DR. HERBERT BRYAN SLADE (NPI# 1578904546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578904546 |
| Entity Type | Individual |
| Full Name | DR. HERBERT BRYAN SLADE |
| Credential | M.D. |
| Practice Address |
855 Montgomery St Suite 100 Fort Worth TX 76107-2553 |
| Mailing Address |
3909 Hulen St Fort Worth TX 76107-7253 |
| Practice Telephone | 8177350349 |
| Mailing Telephone | 8173023919 |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
38335 | MN | Allopathic & Osteopathic Physicians |
| Y | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
CE00003 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
855 MONTGOMERY ST SUITE 100 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 207KI0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Clinical & Laboratory Immunology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561358 | Bnb Diagnostics, LLC | Allergy & Immunology | 350 Nursery Rd Ste 3102, Spring, TX 77380-4079 | 2020-09-08 |
| 1073631404 | West Texas Allergy, Pa | Allergy & Immunology | 5000 Briarwood Ave, Midland, TX 79707-2753 | 2007-03-26 |
| 1003812595 | Niran Jan Amar | Allergy & Immunology | 333 Londonderry Dr, Ste 100, Waco, TX 76712-7930 | 2005-06-21 |
| 1174149967 | Derrick Wayne Ratcliff Jr. | Allergy & Immunology | 14405 Walters Rd, Houston, TX 77014-1337 | 2020-06-17 |
| 1790107977 | Darryl Johnson | Allergy & Immunology | 7457 Harwin Dr Ste 210, Houston, TX 77036-2024 | 2014-01-07 |
| 1134305626 | Paul G Vigo Md Pa | Allergy & Immunology | 720 W 34th St, Suite 200, Austin, TX 78705-1205 | 2008-01-14 |
| 1649469933 | Gordon B. Strom,jr. Md Facp | Allergy & Immunology | 2850 Lewis Ln, Ste. 111, Paris, TX 75460-9378 | 2007-10-23 |
| 1700945342 | John Andrew Grant Jr. | Allergy & Immunology | 301 University Blvd, John Sealy Annex 5.112, Galveston, TX 77555-0561 | 2006-12-08 |
| 1194795450 | Mcgovern Allergy Clinic, P.a. | Allergy & Immunology | 4710 Bellaire Blvd, Suite 200, Bellaire, TX 77401-4526 | 2006-01-26 |
| City | FORT WORTH |
| Zip Code | 76107 |
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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.