BENJAMIN EARL BRACKETT (NPI# 1881872018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881872018 |
| Entity Type | Individual |
| Full Name | BENJAMIN EARL BRACKETT |
| Credential | P.A.-C |
| Practice Address |
2550 River Park Dr Suite 110 Fort Worth TX 76116-0920 |
| Practice Telephone | 8177311289 |
| Practice Fax Number | 8177311291 |
| Mailing Telephone | 8177311289 |
| Mailing Fax Number | 8177311291 |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2016-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA05586 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1959926-01 | 05 | |
| TX | 195992602 | 05 | |
| TX | 195992604 | 05 | |
| TX | 195992603 | 05 | |
| TX | PENDING | 05 |
| Street Address |
2550 RIVER PARK DR SUITE 110 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76116-0920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053313882 | Kwaku A Osafo-mensah | Internal Medicine | 2550 River Park Dr, Suite 100, Fort Worth, TX 76116-0921 | 2005-08-11 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
| 1629681952 | Anum Bashwani | Physician Assistant | 5601 Bridge St Ste 450, Fort Worth, TX 76112-2305 | 2020-08-26 |
| 1780200881 | Emily Brown Holloway | Physician Assistant | 1904 Turner Ridge Dr Apt 5202, Fort Worth, TX 76110-2499 | 2020-06-24 |
| 1679196570 | Maria Cristela Mosso | Physician Assistant | 4521 S Hulen St Ste 118, Fort Worth, TX 76109-4954 | 2020-05-26 |
| 1679195978 | Jacob Torre | Physician Assistant | 1701 River Run Ste 1118, Fort Worth, TX 76107-6557 | 2020-05-11 |
| 1871122382 | Kenaud Jeune | Physician Assistant | 5817 Fairglen Ave Apt 312, Fort Worth, TX 76137-6810 | 2020-04-06 |
| 1922635648 | Lauren Elizabeth Studey | Physician Assistant | 3470 Sagecrest Ter, Fort Worth, TX 76109-2555 | 2020-03-24 |
| 1033743612 | James Bregg Reedy | Physician Assistant | 200 W Magnolia Ave Ste 201, Fort Worth, TX 76104-7657 | 2020-02-24 |
| 1992335194 | Alexandria Christine Rios | Physician Assistant | 5904 Rockhill Rd, Fort Worth, TX 76112-3047 | 2020-01-16 |
| 1982253605 | Kelly Ann Klein | Physician Assistant | 6708 River Bend Rd, Fort Worth, TX 76132-1108 | 2019-09-05 |
| 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.