RICHARD BRIAN BUTORAC (NPI# 1669427290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669427290 |
| Entity Type | Individual |
| Full Name | RICHARD BRIAN BUTORAC |
| Credential | IDC |
| Practice Address |
1711 Doolittle Ave Fort Worth TX 76179 |
| Mailing Address |
5113 Bayridge Ct Fort Worth TX 76179-4255 |
| Practice Telephone | 9045882906 |
| Mailing Telephone | 9045882906 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1711 DOOLITTLE AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528468444 | Luciana Ramirez | Dentist | 1711 Doolittle Ave, Fort Worth, TX 76127 | 2014-08-28 |
| 1922410554 | Naval Health Clinic Corpus Christi | Military/U.S. Coast Guard Pharmacy | 1711 Doolittle Ave, Fort Worth, TX 76127 | 2014-06-02 |
| 1487079356 | Jacob Alan Seekins | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2014-02-28 |
| 1417389461 | Michael A Rivard | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2013-08-01 |
| 1710228226 | Scott Bailey Hughey | General Practice | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2013-03-07 |
| 1609168996 | Richard Thomas Gilbert | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2011-05-05 |
| 1073784245 | Epifanio Elizondo | Physician Assistant | 1711 Doolittle Ave, Nas Jrb Branch Clinic, Fort Worth, TX 76127-1133 | 2008-03-17 |
| 1124235445 | John David Brabner | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1711 | 2007-05-17 |
| 1356318315 | James Kevin Campbell | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2006-03-08 |
| 1952378614 | Amy Elyse Isaia | Psychologist | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2006-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992347215 | Katherine M Wright | Behavior Technician | 5804 Boat Club Road, Fort Worth, TX 76179 | 2019-10-09 |
| 1982245775 | Makaylin Rene Mayes | Behavior Technician | 5804 Boat Club Rd, Fort Worth, TX 76179 | 2019-10-02 |
| 1881246049 | Renkuntla Pllc | Dentist | 240 S Saginaw Blvd, Saginaw, TX 76179 | 2019-07-09 |
| 1376062026 | Michele Ann Taylor | Massage Therapist | 6352 Stone Lake Drive, Fort Worth, TX 76179 | 2017-09-13 |
| 1649796921 | Amanda Williams | Music Therapist | 6212 Rocky Point Trail, Lake Worth, TX 76179 | 2017-08-17 |
| 1912437922 | Dentists of Eagle Mountain, PC | Dentist | 4624 West Bailey Boswell Road, Suite 200, Fort Worth, TX 76179 | 2017-06-13 |
| 1982059283 | 11th Hour Counseling | Social Worker | 949 Sherry Ln, Saginaw, TX 76179 | 2016-04-25 |
| 1114307212 | Stephanie Lee Beavers | Chiropractor | 524 Buckstone Dr., Saginaw, TX 76179 | 2015-06-03 |
| 1760885297 | Kali Nagabalaji | Pharmacy | 200 W J Boaz Rd, Ste 100, Saginaw, TX 76179 | 2014-09-29 |
| 1750794541 | Julie Norwood | Dentist | 1453 N. Saginaw Blvd., Suite 150, Saginaw, TX 76179 | 2014-06-09 |
| Find all providers in zip 76179 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487079356 | Jacob Alan Seekins | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2014-02-28 |
| 1417389461 | Michael A Rivard | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2013-08-01 |
| 1609168996 | Richard Thomas Gilbert | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2011-05-05 |
| 1124235445 | John David Brabner | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1711 | 2007-05-17 |
| 1356318315 | James Kevin Campbell | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225581481 | Kenneth Perry Vantassel | Military Health Care Provider | 1410 Woodfair Dr, Richmond, TX 77406-6609 | 2016-07-24 |
| 1528430980 | Tomasz Orent | Military Health Care Provider | 26885 Manor Falls Dr, Kingwood, TX 77339-7709 | 2015-10-26 |
| 1518337013 | John Cantu | Military Health Care Provider | 3945 Tripoli Dr, Corpus Christi, TX 78415-3348 | 2015-09-28 |
| 1699144428 | Alberto Gonzalez | Military Health Care Provider | 102 Redrock Dr, San Antonio, TX 78213-4526 | 2015-09-22 |
| 1275938375 | Ricardo Jaramillo | Military Health Care Provider | 7016 Austrian Pine, Brownsville, TX 78526 | 2014-10-31 |
| 1942637087 | Matthew Alan Robichaux | Military Health Care Provider | 13500 White Tail Trl, Austin, TX 78736-7422 | 2013-10-03 |
| 1417223710 | Adam Anthony Garcia | Military Health Care Provider | 12080 Paseo De Amor Ln, El Paso, TX 79936-4499 | 2012-03-30 |
| 1124306329 | David G Morales Jr. | Military Health Care Provider | 9180 Tenango Dr, El Paso, TX 79907-3257 | 2011-07-22 |
| 1689970535 | Michael G. Phillips | Military Health Care Provider | 2621 Las Brisas St, Corpus Christi, TX 78414-5014 | 2011-02-09 |
| 1912208216 | Shepley Allen Reimer | Military Health Care Provider | 3555 Patch Rd, Fort Sam Houston, TX 78234-1200 | 2010-11-03 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76179 |
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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.