NPIMap

Individual provider Active NPI

Lawrence Daniel Brotman, M.D.

  • Specialist
  • Fort Worth, TX
National Provider Identifier
1982616207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
30587 Issued in MA
Practice address
6732 Crooked Stick Dr
Fort Worth, TX 76132-4536
Phone
(817) 423-9534
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 30587 MA Primary

Addresses

Primary practice location

6732 Crooked Stick Dr
Fort Worth, TX 76132-4536

Mailing address

6732 Crooked Stick Dr
Fort Worth, TX 76132-4536
Phone (817) 423-9534

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

OrganizationSpecialtyStatusNew patients
Essent PRMC LP Past Accepting new patients
Diagnostic Health Centers of Texas, Limited Partnership Past Accepting new patients
Southside Community Hospital, Inc. Past Accepting new patients
Centra Health Inc Past Accepting new patients
Glen Rose Medical Foundation Inc. Past Accepting new patients
Boston University Medical Center Radiologists, Inc. Past Accepting new patients
Glen Rose Medical Foundation Past Accepting new patients
Umass Memorial Radiology Phys Serv Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982616207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6732 CROOKED STICK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324536",
            "telephone_number": "817-423-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6732 CROOKED STICK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324536",
            "telephone_number": "817-423-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTMAN",
        "first_name": "LAWRENCE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "30587",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.