NPIMap

Organization Active NPI

Bjelland Corp

  • Family Medicine Physician
  • Magnolia, TX
National Provider Identifier
1952844813
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q0169 Issued in TX
Legal business name
BJELLAND CORP
Practice address
41922 N Mill Dr
Magnolia, TX 77354-1850
Phone
(210) 602-5578
NPI assigned
Nov 28, 2016
Last updated
Nov 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Authorized official

Name
Mical Samuelson Duvall, MDNPI 1669600524
Title
Ceo
Phone
(210) 602-5578

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q0169 TX Primary
Pain Medicine Physician 208VP0000X Q0169 TX
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X N8628 TX

Addresses

Primary practice location

41922 N Mill Dr
Magnolia, TX 77354-1850

Mailing address

41922 N Mill Dr
Magnolia, TX 77354-1850
Phone (210) 602-5578

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1952844813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41922 N MILL DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541850",
            "telephone_number": "210-602-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41922 N MILL DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541850",
            "telephone_number": "210-602-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BJELLAND CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "MICAL",
        "authorized_official_middle_name": "SAMUELSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-602-5578",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q0169",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "Q0169",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "TX",
            "license": "N8628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.