NPIMap

Organization Active NPI

Danette R. Elliott-Mullens, DO, PA

  • Internal Medicine Physician
  • New Braunfels, TX
National Provider Identifier
1275742173
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K9775 Issued in TX
Legal business name
DANETTE R. ELLIOTT-MULLENS, DO, PA
Practice address
2660 E. Common St.
Ste #201
New Braunfels, TX 78130-3168
Phone
(830) 627-3385
Fax
(830) 620-0294
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Authorized official

Name
Dr. Danette Rai Elliott-Mullens, DONPI 1417977042
Title
Owner/President
Phone
(830) 627-3385

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X K9775 TX Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X K9775 TX

Addresses

Primary practice location

2660 E. Common St.
Ste #201
New Braunfels, TX 78130-3168

Mailing address

2660 E. Common St.
Ste. #201
New Braunfels, TX 78130-3168
Phone (830) 627-3385

Other identifiers 2

IdentifierTypeStateIssuer
006QFOtherTXBCBS GROUP PROV #
154062701MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1275742173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 E. COMMON ST.",
            "address_2": "STE. #201",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781303168",
            "telephone_number": "830-627-3385",
            "fax_number": "830-620-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 E. COMMON ST.",
            "address_2": "STE #201",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781303168",
            "telephone_number": "830-627-3385",
            "fax_number": "830-620-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANETTE R. ELLIOTT-MULLENS, DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT-MULLENS",
        "authorized_official_first_name": "DANETTE",
        "authorized_official_middle_name": "RAI",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "830-627-3385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K9775",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K9775",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROV #",
            "identifier": "006QF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154062701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.