DR. DOUGLAS WADE WARDEN (NPI# 1205032489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205032489 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS WADE WARDEN |
| Credential | M.D. |
| Practice Address |
3445 Executive Center Drive Suite 250 Austin TX 78731-1678 |
| Practice Telephone | 5125794000 |
| Practice Fax Number | 5124392814 |
| Mailing Telephone | 5125794000 |
| Mailing Fax Number | 5124392814 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
P2395 | TX | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
25708 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 305116101 | 05 |
| Street Address |
3445 EXECUTIVE CENTER DRIVE SUITE 250 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78731-1678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164488912 | Ann Riopel White | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2006-04-21 |
| 1962795740 | Rodolfo Jose Nudelman | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2011-05-26 |
| 1578881413 | Jennifer Robbin Rushton | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2010-05-15 |
| 1679700363 | Armen G Kasyan | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2009-06-19 |
| 1679763833 | Chandra Krishnan | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2007-07-25 |
| 1104020775 | Grace Nightingale Cortez Jackson | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2007-06-14 |
| 1083838809 | Christine Burgess Kost | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2007-04-12 |
| 1376675371 | Amanda Christine Rivera-begeman | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2007-03-12 |
| 1114947603 | Kimberly A Monnin | Specialist | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2006-07-20 |
| 1295778520 | Paul Joseph Michaels | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2006-06-14 |
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| 1033710892 | Anew Era Tms & Psychiatry of Texas, Pa | Psychiatry & Neurology | 7514 N Mopac Expressway, Suite 100, Austin, TX 78731 | 2020-11-06 |
| 1962016519 | Jennie Rose Posey | Clinical Nurse Specialist | 6500 N. Mopac Expressway, Building 3, Suite 200, Austin, TX 78731 | 2020-09-01 |
| 1437772373 | Sharon Polackal | Student in an Organized Health Care Education/Training Program | Shoal Creek Hospital, 3501 Mills Avenue, 6th Floor, Austin, TX 78731 | 2020-05-27 |
| 1699309773 | Modern Vision Group, Pllc | Optometrist | 3908 Far W Blvd, Austin, TX 78731 | 2020-02-27 |
| 1235699562 | Catherine Kerrigan | Social Worker | 7514 N Mopac Expy, Suite 100, Austin, TX 78731 | 2019-03-22 |
| 1912474651 | Austin Dental Spa, Pllc | Dentist | 3305 Northland Ste 515, Austin, TX 78731 | 2018-10-31 |
| 1982110938 | Lindsey Sheppard | Dietitian, Registered | 7000 N Mopac Expy, Suite 200, Austin, TX 78731 | 2017-12-28 |
| 1144746066 | Sarah Cotton | Occupational Therapist | 3520 Executive Center Drive, Suite 128, Austin, TX 78731 | 2017-08-22 |
| 1699299792 | Avoia Mia Tapia | Physical Therapist | 3721 Executive Center Drive, Suite 201, Austin, TX 78731 | 2017-07-31 |
| 1265889745 | Home Focus Aba | Behavioral Analyst | 6804 Capital of Tx Hwy N 412, Austin, TX 78731 | 2016-05-16 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831431766 | Max Michael Wells | Pathology | 3608 Woodcutters Way, Austin, TX 78746-1541 | 2013-03-18 |
| 1538445937 | Thyroid Cytopathology Partners Pa | Pathology | 12357 A Riata Trace Parkway, Bldg. 5, Suite 100, Austin, TX 78727 | 2011-10-30 |
| 1164488912 | Ann Riopel White | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2006-04-21 |
| 1285695577 | Robert Emmet Connor | Pathology | 9200 Wall St, Austin, TX 78754-4534 | 2006-03-28 |
| 1922088756 | Mary E Vono | Pathology | 3445 Executive Center Dr Ste 250, Austin, TX 78731-1678 | 2006-01-18 |
| 1922080894 | Joseph Paul Pulcini | Pathology | 3445 Executive Center Dr, Suite 250, Austin, TX 78731-1678 | 2005-11-16 |
| 1477534535 | Heather Bonnie Rytting | Pathology | 3603 Bridle Path, Austin, TX 78703-2646 | 2005-11-07 |
| 1104807221 | Vilmos A Thomazy | Pathology | 12221 N Mopac Expressway, Namc Department of Pathology, Austin, TX 78756 | 2005-11-07 |
| 1386647022 | Leslie W Dalton IIi | Pathology | 901 W Ben White Blvd, Austin, TX 78704-6903 | 2005-05-26 |
| 1730574971 | Nkechi A Okonkwo | Pathology | 3445 Executive Center Dr, Ste 250, Austin, TX 78731-1678 | 2015-04-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.