Individual provider Active NPI

Delores S Mullinax, OTR

  • Specialist
  • Dallas, TX
National Provider Identifier
1407079965
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
101074 Issued in TX
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
101074TXMDSpecialist

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.

Verify at the official NPI Registry.