Southlake Physical Medicine PLLC
NPI 1083088900 · Internal Medicine Physician · Southlake, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southlake Physical Medicine PLLC is a Internal Medicine Physician organization in Southlake, TX (NPI 1083088900).
Provider details
- NPI number
- 1083088900
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gary Tigges, Medical Director(972) 981-8345
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-11-16
- Last updated
- 2016-04-29
Frequently asked questions
- What is Southlake Physical Medicine PLLC's NPI number?
- Southlake Physical Medicine PLLC's National Provider Identifier (NPI) is 1083088900, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southlake Physical Medicine PLLC?
- Southlake Physical Medicine PLLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Southlake Physical Medicine PLLC located?
- Southlake Physical Medicine PLLC's practice location on file with NPPES is 1500 W Southlake Blvd, Southlake, TX 76092-5950.
- What is Southlake Physical Medicine PLLC's phone number?
- The practice phone number listed in the NPPES registry for Southlake Physical Medicine PLLC is (817) 416-6116.
- Does Southlake Physical Medicine PLLC accept Medicare?
- Southlake Physical Medicine PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southlake Physical Medicine PLLC?
- The authorized official listed on Southlake Physical Medicine PLLC's NPPES record is Gary Tigges, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southlake Physical Medicine PLLC's NPI active?
- Yes — Southlake Physical Medicine PLLC's NPI (1083088900) is active in the NPPES registry as of the last update on 2016-04-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.