NPIMap

Organization Active NPI

M.Gayle Mullanax, MD PA

Doing business as Mullanax Dermatology Associates

  • Dermatology Physician
  • Arlington, TX
National Provider Identifier
1013130426
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D1750 Issued in TX
Legal business name
M.GAYLE MULLANAX, MD PA
Doing business as
Mullanax Dermatology Associates
Practice address
715 N Fielder Rd
Arlington, TX 76012-4695
Phone
(817) 261-1626
Fax
(817) 275-0441
NPI assigned
Apr 11, 2007
Last updated
Jun 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Milton Gayle Mullanax, M.D.NPI 1700932076
Title
Owner
Phone
(817) 261-1626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D1750 TX Primary

Addresses

Primary practice location

715 N Fielder Rd
Arlington, TX 76012-4695

Mailing address

715 N Fielder Rd
Arlington, TX 76012-4695
Phone (817) 261-1626

Other identifiers 1

IdentifierTypeStateIssuer
0007DQOtherTXBCBS OF TEXAS

Other names 1

  • MULLANAX DERMATOLOGY ASSOCIATES Doing business as

National Provider Directory

National Provider Directory

Locations

811 W I 20
Ste 40
Arlington, TX 76017
Phone (817) 466-8651

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1013130426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "817-261-1626",
            "fax_number": "817-275-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "817-261-1626",
            "fax_number": "817-275-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.GAYLE MULLANAX, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "MULLANAX",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-261-1626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "D1750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "0007DQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MULLANAX DERMATOLOGY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.