Daniel Dalton Dubose, MD, PA

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

DANIEL DALTON DUBOSE, MD, PA

Practice address

201 Crown Pointe Blvd Ste 200
Willow Park, TX 76087-1304

Phone

(817) 989-9733

Fax

(817) 989-9723

NPI assigned

Mar 11, 2020

Organization subpart

No

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

Authorized official

Name

Daniel Dalton Dubose, MDNPI 1548649296

Title

Owner

Phone

(817) 989-9733

Specialties & licenses 1

Addresses

Other names 1

• D3 Pain Management Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Dubose, M.D.

  • Anesthesiology Physician
  • Temple, TX
  • NPI 1548649296
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Leblanc, RN, ACNP

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
  • NPI 1235568429
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1104451079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CROWN POINTE BLVD STE 200",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871304",
            "telephone_number": "817-989-9733",
            "fax_number": "817-989-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CROWN POINTE BLVD STE 200",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871304",
            "telephone_number": "817-989-9733",
            "fax_number": "817-989-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL DALTON DUBOSE, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "DALTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-989-9733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D3 Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald Leon Cook, DDS
• Lindsey Coomer, LPC-A
• Marina Coulter, MD
• Crown Pointe Dentistry, PA
• Lindsey Ann Cunningham, PTA
• Caleb Davis
• Lydia Deanda
• Lauren Debolt
• Misty Diaz
• Matthew Dobbins, DPT

• Pain Medicine (Anesthesiology) Physician in Willow Park, TX
• Providers in Willow Park, TX by specialty
• Pain Medicine (Anesthesiology) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.