DR. GARY LEE DOUGLAS (NPI# 1205091683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205091683 |
| Entity Type | Individual |
| Full Name | DR. GARY LEE DOUGLAS |
| Credential | MD |
| Practice Address |
4020 Edgehill Rd Fort Worth TX 76116-7325 |
| Practice Telephone | 8173773352 |
| Mailing Telephone | 8173773352 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
J6924 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477041010 | Gary Ralph Douglas | Chiropractor | 3077 E Commercial Blvd # 1a, Fort Lauderdale, FL 33308-4311 | 2018-04-30 |
| 1235587080 | Gary Douglas | Case Manager/Care Coordinator | 1415 Truxtun Ave, Bakersfield, CA 93301-5215 | 2016-06-01 |
| 1205133618 | Gary Douglas | Counselor | 115 Rockwood Ln, Hazard, KY 41701-9415 | 2011-02-21 |
| 1922096668 | Gary Douglas | Surgery | 1026 Union Rd, West Seneca, NY 14224-3449 | 2005-10-06 |
| Street Address |
4020 EDGEHILL RD |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76116-7325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908980 | William Michael Marshall | Pharmacist | 8600 Camp Bowie Blvd, Forth Worth, TX 76116 | 2020-10-02 |
| 1558843599 | Donnisha Bunting | In Home Supportive Care | 2901 Broadmoor, 1115, Fort Worth, TX 76116 | 2018-09-06 |
| 1588156756 | Bilal Master | Student in an Organized Health Care Education/Training Program | 3309 Riveroad Court, 2515, Ft Worth, TX 76116 | 2018-06-04 |
| 1245769728 | Randall R Williams | Physical Therapist | 6913 Camp Bowie Blvd Suite 141, Fort Worth, TX 76116 | 2017-06-08 |
| 1023543048 | 5th Avenue Grooming Lounge | Prosthetic/Orthotic Supplier | 1201 N Watson Rd., Suite 283, Arlington, TX 76116 | 2017-04-27 |
| 1831647734 | Frisco Neuro Collaborations, Pllc | Physician Assistant | 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 | 2016-09-20 |
| 1104288372 | Brown Mobile Dental Pa | Dentist | 8008 Camp Bowie W Blvd, Ste 101, Fort Worth, TX 76116 | 2016-03-25 |
| 1639553431 | Bartholomew A Akubukwe | Pharmacist | 6700 Westfree Way, Fortworth, TX 76116 | 2015-07-13 |
| 1952718868 | Brown Mobile Dental | Dentist | 8008 Camp Bowie Suite 101, Fort Worth, TX 76116 | 2014-07-14 |
| 1275949018 | Emily Sue Danner | Dentist | 6726 Camp Bowie Blvd., Fort Worth, TX 76116 | 2014-07-01 |
| Find all providers in zip 76116 | ||||
| Taxonomy Code | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760619878 | John D Roaten | Orthopaedic Surgery | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2009-06-16 |
| 1699912469 | Jason Matthew Kennedy | Orthopaedic Surgery | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2009-01-14 |
| 1679789424 | Matthew Eugene Mayfield | Orthopaedic Surgery | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093280463 | Baylor College of Medicine | Orthopaedic Surgery | 6363 San Felipe St Ste 150, Houston, TX 77057-2704 | 2018-10-11 |
| 1184945297 | Kathryn Denise Wiesman | Orthopaedic Surgery | 3533 South Alameda, Corpus Christi, TX 78411 | 2010-06-13 |
| 1477758050 | Jaclyn F Hill | Orthopaedic Surgery | 6701 Fannin St Ste 660, Ms Ccc660, Houston, TX 77030-2610 | 2007-06-15 |
| 1205047867 | Robert D Graham, Md | Orthopaedic Surgery | 12176 N Mopac Expy, Suite D, Austin, TX 78758-2908 | 2007-05-25 |
| 1902025000 | Samer Tawakkol Md Pa | Orthopaedic Surgery | 12121 Richmond Ave Ste 408, Houston, TX 77082-2439 | 2007-04-25 |
| 1770610636 | Southern Orthopaedics & Sports Medicine Pa | Orthopaedic Surgery | 5009 S Mccoll Road, Edinburg, TX 78539 | 2007-02-27 |
| 1962422386 | David Scott Brown | Orthopaedic Surgery | 245 West State Highway 114, Suite 300, Southlake, TX 76092 | 2006-07-20 |
| 1528003076 | Pediatric Orthopedic Associates of San Antonio | Orthopaedic Surgery | 4499 Medical Dr., Suite 235, San Antonio, TX 78229-3712 | 2006-06-18 |
| 1821050600 | Philip L Wilson | Orthopaedic Surgery | 5700 Dallas Pkwy, Frisco, TX 75034-9580 | 2006-04-05 |
| 1447224357 | Earl Austin Stanley Jr. | Orthopaedic Surgery | 8300 Floyd Dr, 3rd Fl -3c, San Antonio, TX 78229 | 2006-02-15 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76116 |
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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.