BAYLEN CLINT BASTIBLE (NPI# 1568401594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568401594 |
| Entity Type | Individual |
| Full Name | BAYLEN CLINT BASTIBLE |
| Credential | PA-C |
| Practice Address |
6551 Harris Pkwy Suite 250 Fort Worth TX 76132-6103 |
| Mailing Address |
Po Box 100189 Fort Worth TX 76185-0189 |
| Practice Telephone | 8172636116 |
| Practice Fax Number | 8172636117 |
| Mailing Telephone | 8177310230 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2019-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA04507 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6551 HARRIS PKWY SUITE 250 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76132-6103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264443 | David Atteberry Nethery | Ophthalmology | 6551 Harris Pkwy, Ste 200, Fort Worth, TX 76132-6102 | 2005-06-08 |
| 1407907348 | Michael Jack Bradley | Technician/Technologist | 6551 Harris Pkwy, Ste 205, Fort Worth, TX 76132-6103 | 2007-01-16 |
| 1538170485 | Clearwater Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 6551 Harris Pkwy, Suite 100, Fort Worth, TX 76132-6103 | 2006-08-10 |
| 1497714026 | Kenneth J Buley | Physical Medicine & Rehabilitation | 6551 Harris Pkwy, Suite 110, Fort Worth, TX 76132-6105 | 2006-03-22 |
| 1386624476 | David Maldonado IIi | Internal Medicine | 6551 Harris Pkwy, Suite 250, Fort Worth, TX 76132-6103 | 2006-01-17 |
| 1831196088 | Karl Bruno Brandenberg | Ophthalmology | 6551 Harris Pkwy, Suite 200, Fort Worth, TX 76132-6102 | 2005-07-01 |
| 1740287994 | David A. Nethery, M.d., P.a. | Ophthalmology | 6551 Harris Pkwy, Suite 200, Fort Worth, TX 76132-6102 | 2005-07-01 |
| 1659378800 | Cityview Surgery Center, Ltd. | Clinic/Center | 6551 Harris Pkwy, Suite 100, Fort Worth, TX 76132-6102 | 2005-07-01 |
| 1871590471 | Joan L Abernethy | Ophthalmology | 6551 Harris Pkwy, Suite 200, Fort Worth, TX 76132-6103 | 2005-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669843 | Rubilene Spinks | Pharmacist | 6300 Oakmount Blvd, Fort Worth, TX 76132 | 2020-11-03 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1568029320 | Ty Desilets | Physical Therapist | 5959 Bryant Irvin Rd Suite 100, Fort Worth, TX 76132 | 2019-05-28 |
| 1750844049 | Fort Worth Surgical Center Lp | Clinic/Center | 6949 Bryant Irvin Road, Fort Worth, TX 76132 | 2019-04-12 |
| 1063971232 | Symetria Health of Texas, LLC | Clinic/Center | 7299 Hawkins View Drive, Fort Worth, TX 76132 | 2019-03-18 |
| 1275015612 | Falguni Udayan Patel | Nurse Practitioner | 6100 Harris Pkwy Ste 1230, Fort Worth, TX 76132 | 2018-09-02 |
| 1881110161 | Because De Cares | Private Vehicle | 7101 Bryant Irving Road #33104, Fort Worth, TX 76132 | 2017-08-17 |
| 1871045708 | Cns - F.w., LLC | Clinic/Center | 6940 Harris Parkway, Fort Worth, TX 76132 | 2016-10-26 |
| 1790233294 | Prime Diagnostic Imaging of Fort Worth, LLC | Clinic/Center | 6491 Southwest Blvd., Benbrook, TX 76132 | 2016-09-14 |
| Find all providers in zip 76132 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598314742 | Tan Ngo | Physician Assistant | 3025 N Tarrant Pkwy Ste 140, Fort Worth, TX 76177-8625 | 2019-09-10 |
| 1699321240 | Hannah Bram | Physician Assistant | 1400 8th Ave Fl 1, Fort Worth, TX 76104-4110 | 2019-08-09 |
| 1942654462 | Damon A Cates | Physician Assistant | Fmc Carswell, J St Bldg 3000, Fort Worth, TX 76127 | 2016-04-21 |
| 1790159721 | Victoria Constant | Physician Assistant | 3701 Vision Dr Ste 101, Fort Worth, TX 76109-1184 | 2015-11-13 |
| 1962828871 | Erika Zuniga Martinez | Physician Assistant | 800 7th Ave, Fort Worth, TX 76104-2704 | 2014-03-16 |
| 1336562883 | Elizabeth Suzanne Widmer | Physician Assistant | 12469 Timberland Blvd Ste 501, Fort Worth, TX 76244-5216 | 2014-02-03 |
| 1225475536 | Female Health Associates of North Texas, LLC | Physician Assistant | 1327 Hemphill St, Suit 100, Fort Worth, TX 76104-4735 | 2013-05-28 |
| 1427255330 | Alhaji Mahama Mumuni | Physician Assistant | 3305 Miller Ave Ste B, Fort Worth, TX 76119-1956 | 2007-07-03 |
| 1427144518 | Glenda Rose Hagman | Physician Assistant | 1400 S Main St Ste 406, Fort Worth, TX 76104-4913 | 2006-10-05 |
| 1073533725 | Michael Howard Johnson | Physician Assistant | 4504 Boat Club Rd Ste 800, Fort Worth, TX 76135-7002 | 2006-07-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76132 |
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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.