Provider Demographics
NPI:1306934435
Name:BUMANN, TIMOTHY P (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:P
Last Name:BUMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 EAST EUREKA STREET
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-6546
Mailing Address - Country:US
Mailing Address - Phone:817-596-7000
Mailing Address - Fax:817-596-7001
Practice Address - Street 1:6250 ANTILLEY RD
Practice Address - Street 2:ABILENE REGIONAL WOUND CARE CENTER
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5742
Practice Address - Country:US
Practice Address - Phone:325-428-2807
Practice Address - Fax:325-428-2819
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7177207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P5030OtherBLUE CROSS
TX137859812Medicaid
TXP00133197OtherRAILROAD MEDICARE
TX8672B7Medicare PIN
TX8P5030OtherBLUE CROSS