Active NPI
Delores S Mullinax, OTR
- Specialist
- Dallas, TX
National Provider Identifier
1407079965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 101074
- Practice address
- 1353 N Westmoreland Rd
BLDG. F
Dallas, TX 75211-1655 - Phone
- (214) 333-7063
- Fax
- (214) 333-7097
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 101074 | TX | Primary |
Addresses
Primary practice location
1353 N Westmoreland Rd
BLDG. F
Dallas, TX 75211-1655
Mailing address
1210 Olde Towne Dr
Irving, TX 75061-6155
Phone (972) 790-5139
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 |
|---|---|---|---|
| 101074 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407079965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 OLDE TOWNE DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750616155",
"telephone_number": "972-790-5139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1353 N WESTMORELAND RD",
"address_2": "BLDG. F",
"city": "DALLAS",
"state": "TX",
"postal_code": "752111655",
"telephone_number": "214-333-7063",
"fax_number": "214-333-7097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINAX",
"first_name": "DELORES",
"middle_name": "S",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "101074",
"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.