Brent Bultemeier PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5532 Issued in TX

Legal business name

BRENT BULTEMEIER PA

Practice address

3207 New Boston Road
Texarkana, TX 75501

Phone

(903) 832-8765

Fax

(903) 832-6060

NPI assigned

Mar 28, 2007

Last updated

Aug 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brent Stewart Bultemeier, D.C.NPI 1821104332

Title

President

Phone

(903) 832-8765

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Brent Stewart Bultemeier, D.C.

  • Chiropractor
  • Texarkana, TX
  • NPI 1821104332
  NPD (past) Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1134248271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 NEW BOSTON ROAD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75501",
            "telephone_number": "903-832-8765",
            "fax_number": "903-832-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 NEW BOSTON ROAD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75501",
            "telephone_number": "903-832-8765",
            "fax_number": "903-832-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT BULTEMEIER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "BULTEMEIER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-832-8765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TX",
            "identifier": "0072QD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE5478",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa La'Page Bragg, PT, DPT
• Kathryn E Brannan, FNP
• Jamie Brantley, FNP
• Terry Vincent Braswell, D.D.S.
• Rudy Maeda Braza, M.D.
• Forestt Bridges
• Bridgewater Health Supplies LLC
• Brim Healthcare of Texas LLC
• Brim Healthcare of Texas LLC
• Brim Healthcare of Texas LLC

• Chiropractor in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.