Individual provider Active NPI

David Edward Teitelbaum, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Fort Worth, TX
National Provider Identifier
1366498438
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
G8457 Issued in TX
Practice address
4455 Camp Bowie Blvd
Suite 214
Fort Worth, TX 76107-3864
Phone
(817) 335-4220
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X G8457 TX Primary

Addresses

Primary practice location

4455 Camp Bowie Blvd
Suite 214
Fort Worth, TX 76107-3864

Mailing address

4455 Camp Bowie Blvd
Suite 214
Fort Worth, TX 76107-3864
Phone (817) 335-4220

Other identifiers 1

IdentifierTypeStateIssuer
P000GQ538MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040608000045 TX Practitioner - Osteopathic Manipulative Medicine 7214910736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4455 Camp Bowie Blvd
Suite 214
Ft Worth, TX 76107-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G8457TXMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David E. Teitelbaum, D.O., P.a. Neuromusculoskeletal Medicine & Omm CurrentSince Mar 2, 2013 Accepting new patients

Locations

4455 Camp Bowie Blvd
Ste 214
Ft Worth, TX 76107
Phone (817) 335-4220

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366498438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 CAMP BOWIE BLVD",
            "address_2": "SUITE 214",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073864",
            "telephone_number": "817-335-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 CAMP BOWIE BLVD",
            "address_2": "SUITE 214",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073864",
            "telephone_number": "817-335-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBAUM",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "G8457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000GQ538",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.