MELCHOR MENCHACA BOONE JR. (NPI# 1629084082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629084082 |
| Entity Type | Individual |
| Full Name | MELCHOR MENCHACA BOONE JR. |
| Credential | MD |
| Practice Address |
855 Montgomery St Dept of Ob/gyn Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8179206401 |
| Mailing Telephone | 8179271065 |
| Mailing Fax Number | 8179271162 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | H7914 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8B5597 | 01 |
| TX | 129209607 | 05 | |
| TX | RAILROAD MEDICARE | P00612405 | 01 |
| Street Address |
855 MONTGOMERY ST DEPT OF OB/GYN |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619481637 | Jonathan C. Snead, Md, Pa Dba: Alliance Women's Healthcare | Obstetrics & Gynecology | 10932 N Riverside Dr Ste 100, Fort Worth, TX 76244-7137 | 2017-11-29 |
| 1356888788 | Karen Benz, Md Pa | Obstetrics & Gynecology | 1250 8th Ave Ste 270, Fort Worth, TX 76104-4139 | 2017-01-24 |
| 1164895355 | Steven R. Edmondson Md, Pa | Obstetrics & Gynecology | 3025 N Tarrant Pkwy Ste 240, Fort Worth, TX 76177-8620 | 2015-11-10 |
| 1437542982 | Charles David Braungardt | Obstetrics & Gynecology | 7221 Meadowbrook Dr, Fort Worth, TX 76112-5327 | 2015-03-09 |
| 1962840678 | Madeline Manning | Obstetrics & Gynecology | 6100 Harris Pkwy Ste 235, Fort Worth, TX 76132-4126 | 2013-06-05 |
| 1720378375 | Melissa A Weidert | Obstetrics & Gynecology | 1000 Bonnie Brae Ave, Fort Worth, TX 76111-4301 | 2011-04-17 |
| 1396061826 | Deana Jamal Hussamy | Obstetrics & Gynecology | 1325 Pennsylvania Ave Ste 600, Fort Worth, TX 76104-2133 | 2010-04-08 |
| 1790001360 | Christopher Mark Ripperda | Obstetrics & Gynecology | 1250 8th Ave Ste 330, Fort Worth, TX 76104-4148 | 2010-04-07 |
| 1063744142 | Linda M Bernstein | Obstetrics & Gynecology | 7229 Hawkins View Dr, Fort Worth, TX 76132-3921 | 2010-02-01 |
| 1104157106 | Remedios R. Cabansag, Md, Pa | Obstetrics & Gynecology | 11803 So. Freeway, Suite 254, Fort Worth, TX 76115-0337 | 2010-01-15 |
| Find all providers in FORT WORTH | ||||
| 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.