Active NPI
Wayne Bornstein, C.O.T.A
- Specialist
- Dallas, TX
National Provider Identifier
1235341504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 209067
- Practice address
- 9011 John W Carpenter Fwy
101
Dallas, TX 75247-4525 - Phone
- (214) 699-0330
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 209067 | TX | Primary |
Addresses
Primary practice location
9011 John W Carpenter Fwy
101
Dallas, TX 75247-4525
Mailing address
4703 McKinney Ave
'A'
Dallas, TX 75205-5571
Phone (972) 955-5955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209067 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235341504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4703 MCKINNEY AVE",
"address_2": "'A'",
"city": "DALLAS",
"state": "TX",
"postal_code": "752055571",
"telephone_number": "972-955-5955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9011 JOHN W CARPENTER FWY",
"address_2": "101",
"city": "DALLAS",
"state": "TX",
"postal_code": "752474525",
"telephone_number": "214-699-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORNSTEIN",
"first_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "C.O.T.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "209067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.