David E. Teitelbaum, D.O., P.a.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

G8457 Issued in TX

Legal business name

DAVID E. TEITELBAUM, D.O., P.A.

Practice address

4455 Camp Bowie Blvd
Suite 214
Fort Worth, TX 76107-3864

Phone

(817) 335-4220

Fax

(817) 335-3171

NPI assigned

Aug 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. David Edward Teitelbaum, D.O.NPI 1366498438

Title

President

Phone

(817) 335-4220

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Edward Teitelbaum, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Fort Worth, TX
  • NPI 1366498438
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282435200000",
    "number": "1740596295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 CAMP BOWIE BLVD",
            "address_2": "SUITE 214",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073864",
            "telephone_number": "817-335-4220",
            "fax_number": "817-335-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 CAMP BOWIE BLVD",
            "address_2": "SUITE 214",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073864",
            "telephone_number": "817-335-4220",
            "fax_number": "817-335-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID E. TEITELBAUM, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-22",
        "last_updated": "2010-08-22",
        "status": "A",
        "authorized_official_last_name": "TEITELBAUM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-335-4220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "G8457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neuromusculoskeletal Medicine & OMM Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.