Active NPI
Darrell Wilburn, MD
- Internal Medicine Physician
- Lockhart, TX
National Provider Identifier
1972908432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- H6754
- Practice address
- 1400 E MLK Jr Industrial Blvd
Lockhart, TX 78644-3700 - Phone
- (512) 398-3480
- Fax
- (512) 268-1873
- NPI assigned
- Oct 27, 2014
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | H6754 | TX | Primary |
Addresses
Primary practice location
1400 E MLK Jr Industrial Blvd
Lockhart, TX 78644-3700
Mailing address
1400 E MLK Jr Industrial Blvd
P.O. Box 1170
Lockhart, TX 78644-3700
Phone (512) 398-3480
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H6754 | TX | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1972908432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E MLK JR INDUSTRIAL BLVD",
"address_2": "P.O. BOX 1170",
"city": "LOCKHART",
"state": "TX",
"postal_code": "786443700",
"telephone_number": "512-398-3480",
"fax_number": "512-268-1873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E MLK JR INDUSTRIAL BLVD",
"city": "LOCKHART",
"state": "TX",
"postal_code": "786443700",
"telephone_number": "512-398-3480",
"fax_number": "512-268-1873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBURN",
"first_name": "DARRELL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-27",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "H6754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lockhart, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.