Active NPI
Bertram S. Mullan, M.D.
- Anesthesiology Physician
- Fort Worth, TX
National Provider Identifier
1699733873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- F0266
- Practice address
- 4916 Overton PLZ
Fort Worth, TX 76109-4415 - Phone
- (800) 224-5203
- Fax
- (817) 334-0235
- NPI assigned
- May 3, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | F0266 | TX | Primary |
Addresses
Primary practice location
4916 Overton PLZ
Fort Worth, TX 76109-4415
Mailing address
PO Box 163258
Fort Worth, TX 76161-3258
Phone (800) 224-5203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123791906 | 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 |
|---|---|---|---|
| Regional Employee Assistance Program Inc | Past | Accepting new patients | |
| Brownwood M. D. Anesthesia | Anesthesiology | Past | Accepting new patients |
| Denton Anesthesiology Associates, PA | Anesthesiology | Past | Accepting new patients |
| Regional Employee Assistance Program Inc | Anesthesiology | Past | Accepting new patients |
| Akshay Vakharia M.D.,PLLC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Anesthesiology Physician
- Denton, TX
- NPI 1588622815
Anesthesiology
-
- Cardiovascular Disease Physician
- Abilene, TX
- NPI 1073575585
-
- Family Medicine Physician
- Corsicana, TX
- NPI 1649232984
Anesthesiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358726400000",
"number": "1699733873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 163258",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761613258",
"telephone_number": "800-224-5203",
"fax_number": "817-334-0235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4916 OVERTON PLZ",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761094415",
"telephone_number": "800-224-5203",
"fax_number": "817-334-0235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLAN",
"first_name": "BERTRAM",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2013-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "F0266",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123791906",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.