Active NPI
Ted B Muilenburg
- Prosthetist
- Houston, TX
National Provider Identifier
1619199619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- 407
- Practice address
- 3900 La Branch St
Houston, TX 77004-4046 - Phone
- (713) 524-3949
- Fax
- (713) 524-3915
- NPI assigned
- May 2, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Prosthetist | 224P00000X | 407 | TX | Primary |
Addresses
Primary practice location
3900 La Branch St
Houston, TX 77004-4046
Mailing address
3900 La Branch St
Houston, TX 77004-4046
Phone (713) 524-3949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086146001 | Medicaid | TX |
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 |
|---|---|---|---|
| 407 | TX | MD | Pediatric Sports Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Muilenburg Prosthetics, Inc. | Prosthetist | Current | Accepting new patients |
Locations
3900 La Branch St
Houston, TX 77004
Phone (713) 524-3949
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": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619199619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 LA BRANCH ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770044046",
"telephone_number": "713-524-3949",
"fax_number": "713-524-3915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 LA BRANCH ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770044046",
"telephone_number": "713-524-3949",
"fax_number": "713-524-3915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUILENBURG",
"first_name": "TED",
"middle_name": "B",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "TX",
"license": "407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "086146001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, 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.