JACK LYNWOOD JUDSON, MD (NPI# 1902298417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902298417 |
| Entity Type | Organization |
| Organization Name | JACK LYNWOOD JUDSON, MD |
| Practice Address |
1800 Malibar Rd Fort Worth TX 76116-1834 |
| Practice Telephone | 8177327526 |
| Mailing Telephone | 8177327526 |
| Enumeration Date | 2015-02-21 |
| Last Update Date | 2015-02-21 |
| Authorized Official Name | DR. JACK LYNWOOD JUDSON (OWNER) |
| Authorized Official Telephone | 8177328526 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | C8715 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1800 MALIBAR RD |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76116-1834 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1952870354 | Nancy Carolina Nicoloso | Family Medicine | 6302 Lake Worth Blvd Ste A3963, Fort Worth, TX 76135-3607 | 2018-11-15 |
| 1245717586 | Julia Dubose | Family Medicine | 4100 Heritage Trace Pkwy Ste 116, Fort Worth, TX 76244 | 2018-07-19 |
| 1609307115 | Yara Hamade Gonzales | Family Medicine | 4701 Bryant Irvin Rd, Fort Worth, TX 76132-3603 | 2017-03-26 |
| 1558732321 | Andres Morgado Perez | Family Medicine | 1325 Pennsylvania Ave Ste 750, Fort Worth, TX 76104-2168 | 2015-10-19 |
| 1114304805 | Davis Wellness Ltd LLP | Family Medicine | 3750 S. University Dr., Suite 201, Fort Worth, TX 76109-3701 | 2015-05-01 |
| 1104243468 | Henry Dollahite | Family Medicine | 6205 Locke Ave, Fort Worth, TX 76116-4636 | 2014-03-25 |
| 1447676689 | Janet Shackelford | Family Medicine | 5001 Golden Triangle Blvd, # 1024, Fort Worth, TX 76244 | 2014-03-12 |
| 1083955181 | Esiquiel P. Olivarez, Jr | Family Medicine | 6138 Walraven Cir, Ste A&b, Fort Worth, TX 76133-2769 | 2013-03-14 |
| Find all providers in FORT WORTH | ||||
| 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.