Kristie R Wilburn Wren, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

P4528 Issued in TX

Practice address

5323 Harry Hines Blvd
Dallas, TX 75390-9032

Phone

(214) 648-3280

Fax

(214) 648-7611

NPI assigned

May 31, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• West Tennessee Women'S Health Center

  • Obstetrics & Gynecology Physician
  • Brownsville, TN
  • NPI 1629094461
  NPD (past) Authorized official
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Obstetrics & Gynecology Physician
  • Dallas, TX
  • NPI 1710959135
  NPD
• Dallas County Hospital District

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1932123247
  NPD (past)
• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1295738615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909032",
            "telephone_number": "214-648-3280",
            "fax_number": "214-648-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909032",
            "telephone_number": "214-648-3280",
            "fax_number": "214-648-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN WREN",
        "first_name": "KRISTIE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "39597",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P4528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3330159",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE PIN",
            "identifier": "4105263",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mallory Wightman, LPC-ASSOCIATE
• Carol Wikberg, RN
• Janis M Wilbert, IBCLC
• Jameson Gerhard Wilbur, MD
• Karen Mead Wilbur, PHD
• Abigail Lane Wilburn, COTA
• Kordney Wilburn
• Joyce E Wilcher
• Sandra H. Wilcher, CRNA
• Teaira Wilcher, COTA

• Obstetrics & Gynecology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.

Verify at the official NPI Registry.