1326254160 NPI number — TIMOTHY P. BUMANN D.O. P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326254160 NPI number — TIMOTHY P. BUMANN D.O. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIMOTHY P. BUMANN D.O. P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326254160
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2438 INDUSTRIAL BLVD
Provider Second Line Business Mailing Address:
PMB 105
Provider Business Mailing Address City Name:
ABILENE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79605-7207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-428-2807
Provider Business Mailing Address Fax Number:
325-428-2819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6250 ANTILLEY RD
Provider Second Line Business Practice Location Address:
ABILENE REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
ABILENE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79606-5742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-428-2807
Provider Business Practice Location Address Fax Number:
325-428-2819
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BUMANN
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PHYSICIAN MANAGER
Authorized Official Telephone Number:
325-428-2807

Provider Taxonomy Codes

  • Taxonomy code: 207PE0005X , with the licence number:  G7177 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DB8646 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0003LW . This is a "BLUE CROSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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