Individual provider Active NPI

Don Paul Bunnell, MD

  • Internal Medicine Physician
  • Port Lavaca, TX
National Provider Identifier
1033123799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G3196 Issued in TX
Practice address
1200 North Virginia
Port Lavaca, TX 77979
Phone
(361) 552-6721
Fax
(361) 552-7463
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G3196 TX Primary

Addresses

Primary practice location

1200 North Virginia
Port Lavaca, TX 77979

Mailing address

1101 N Benavides St
Port Lavaca, TX 77979-2922
Phone (361) 552-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000675 TX Practitioner - Internal Medicine 4385711209 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G3196TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center CurrentSince Sep 1, 2015 Accepting new patients
Memorial Medical Center CurrentSince Sep 1, 2015 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial Medical CenterPort Lavaca, TX, CCN 451356 Hospital Corporate Director (10%) Mar 31, 2016
Memorial Medical CenterPort Lavaca, TX, CCN 45Z356 Hospital Corporate Director (10%) Mar 22, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033123799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N BENAVIDES ST",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "779792922",
            "telephone_number": "361-552-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTH VIRGINIA",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "77979",
            "telephone_number": "361-552-6721",
            "fax_number": "361-552-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "DON",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G3196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Lavaca, TX

Sources for this page

Verify at the official NPI Registry.