Provider Demographics
NPI:1740240084
Name:BARTELS, WALTON GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTON
Middle Name:GEORGE
Last Name:BARTELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1505 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1907
Practice Address - Country:US
Practice Address - Phone:254-933-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX807538OtherBLUE SHIELD
TX080170741OtherRR/MEDICARE
TX1010431-01Medicaid
TX1010431-02OtherCSHCN
TX807538Medicare ID - Type Unspecified
TX1010431-01Medicaid