Individual provider Active NPI

Denton Watumull, MD

  • Plastic and Reconstructive Surgery Physician
  • Richardson, TX
National Provider Identifier
1225073216
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
G6096 Issued in TX
Practice address
3201 George Bush Hwy
#101
Richardson, TX 75082-3566
Phone
(972) 470-5000
Fax
(972) 470-5002
NPI assigned
Jun 17, 2006
Last updated
Feb 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) Physician 2086S0105X G6096 TX
Plastic and Reconstructive Surgery Physician 2086S0122X G6096 TX Primary

Addresses

Primary practice location

3201 George Bush Hwy
#101
Richardson, TX 75082-3566

Mailing address

3201 George Bush Hwy
#101
Richardson, TX 75082-3566
Phone (972) 470-5000

Other identifiers 1

IdentifierTypeStateIssuer
PO88X1212MedicaidTX

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
I20120406000154 TX Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 3779520275 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
RPSC Mso Inc Surgery of the Hand CurrentSince Dec 16, 1994 Accepting new patients
Breckenridge Surgery Center LP PastSince Apr 15, 2005 Accepting new patients

Locations

2692 W Walnut St
Ste 101
Garland, TX 75042
Phone (972) 272-4232

3201 George Bush Hwy
Ste 101
Richardson, TX 75082
Phone (972) 470-5000

Organizations & group practices 2

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1225073216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 GEORGE BUSH HWY",
            "address_2": "#101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823566",
            "telephone_number": "972-470-5000",
            "fax_number": "972-470-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 GEORGE BUSH HWY",
            "address_2": "#101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823566",
            "telephone_number": "972-470-5000",
            "fax_number": "972-470-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATUMULL",
        "first_name": "DENTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "G6096",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "G6096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PO88X1212",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.