Formula Wellness PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K1038 Issued in TX

Legal business name

FORMULA WELLNESS PLLC

Practice address

4342 Lovers LN
Dallas, TX 75225-6921

Phone

(214) 931-9443

Fax

(214) 602-2017

NPI assigned

Feb 3, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian Rudman, M.D.NPI 1447281142

Title

Physician/Owner

Phone

(214) 931-9443

Specialties & licenses 3

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian D Rudman, M.D.

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1447281142
  Authorized official Same address or phone
• Sarah Hower

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1295306264
  NPD
• Emeri Jean Bradford, PA-C

  • Physician Assistant
  • Dallas, TX
  • NPI 1508440173
  NPD (past)

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346608536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 LOVERS LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752256921",
            "telephone_number": "214-931-9443",
            "fax_number": "214-602-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 LOVERS LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752256921",
            "telephone_number": "214-931-9443",
            "fax_number": "214-602-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMULA WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RUDMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "214-931-9443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K1038",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129767308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nace Anthony Formagus Jr.
• Susan M Forman, CRNA
• Tonya Forman
• Joseph Luis Formella, MD
• Taisa De Souza Formenti
• Anthony Peter Fornito, MD
• Brad Michael Forquer, DPM
• Forrest C. Brown MD,PA (Consulting Dermatologic Specialists)
• Laura Forrester, LPC-S
• Madeline Forst

• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.