Individual provider Active NPI

Bing Obaldo, MD

  • Diagnostic Radiology Physician
  • Cleburne, TX
National Provider Identifier
1629013370
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
F6057 Issued in TX
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

Updated by the provider on Dec 17, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
114715902MedicaidTX

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

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.