Active NPI
Bing Obaldo, MD
- Diagnostic Radiology Physician
- Cleburne, TX
National Provider Identifier
1629013370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- F6057
- Practice address
- 201 Walls Dr
Cleburne, TX 76033-4008 - Phone
- (817) 202-0355
- Fax
- (817) 202-0009
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Radiology Physician | 2085N0904X | F6057 | TX | |
| Diagnostic Radiology Physician | 2085R0202X | F6057 | TX | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | F6057 | TX |
Addresses
Primary practice location
201 Walls Dr
Cleburne, TX 76033-4008
Mailing address
2119 Lakeshore Dr
Cleburne, TX 76033-6966
Phone (817) 202-0355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114715902 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Imaging Diagnostic Associates | Diagnostic Radiology | Past | Accepting new patients |
| Radcare of Texas PLLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Alice, TX
- NPI 1609831379
-
- Diagnostic Radiology Physician
- Fort Worth, TX
- NPI 1164470845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229472000000",
"number": "1629013370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 LAKESHORE DR",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760336966",
"telephone_number": "817-202-0355",
"fax_number": "817-202-0009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 WALLS DR",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760334008",
"telephone_number": "817-202-0355",
"fax_number": "817-202-0009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBALDO",
"first_name": "BING",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2008-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "TX",
"license": "F6057",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "F6057",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "TX",
"license": "F6057",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114715902",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleburne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.