Organization Active NPI

Dr. Brian Mulhall, PA

  • Sports Physician Chiropractor
  • Fort Worth, TX
National Provider Identifier
1841389293
Registry record updated Dec 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
10037 Issued in TX
Legal business name
DR. BRIAN MULHALL, PA
Practice address
3600 Hulen St
Ste A4
Fort Worth, TX 76107-6863
Phone
(817) 332-5353
Fax
(817) 332-5358
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2012

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

Authorized official

Name
Dr. Brian C Mulhall, DCNPI 1972562981
Title
Owner/President
Phone
(817) 332-5353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 10037 TX Primary

Addresses

Primary practice location

3600 Hulen St
Ste A4
Fort Worth, TX 76107-6863

Mailing address

3600 Hulen St
Ste A4
Fort Worth, TX 76107-6863
Phone (817) 332-5353

Other names 1

  • Active Spine & Sport Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000455 TX Part B Supplier - Clinic/Group Practice 0648215806 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

5521 Bellaire Dr S
Ste 100
Fort Worth, TX 76109
Phone (817) 723-4441

3600 Hulen St
Ste A4
Fort Worth, TX 76107
Phone (817) 332-5353

3200 Collinsworth St
Fort Worth, TX 76107
Phone (817) 332-5353

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356739200000",
    "number": "1841389293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 HULEN ST",
            "address_2": "STE A4",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076863",
            "telephone_number": "817-332-5353",
            "fax_number": "817-332-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 HULEN ST",
            "address_2": "STE A4",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076863",
            "telephone_number": "817-332-5353",
            "fax_number": "817-332-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRIAN MULHALL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-12-29",
        "status": "A",
        "authorized_official_last_name": "MULHALL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "817-332-5353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "10037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Spine & Sport Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 29, 2012; 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.