Active NPI
Denton Watumull, MD
- Plastic and Reconstructive Surgery Physician
- Richardson, TX
National Provider Identifier
1225073216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- G6096
- 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, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PO88X1212 | Medicaid | TX |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RPSC Mso Inc | Surgery of the Hand | Current | Accepting new patients |
| Breckenridge Surgery Center LP | Past | 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.
-
- Plastic and Reconstructive Surgery Physician
- Richardson, TX
- NPI 1306056999
Surgery of the Hand
-
- Ambulatory Surgical Clinic/Center
- Richardson, TX
- NPI 1962568725
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.