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ALBERT C BRODERS III MD
NPI 1699721415
Emergency Medicine in Dallas, TX

Active since May 25, 2006
8200 WALNUT HILL LN, DALLAS, TX 75231(214) 345-6789 Get Directions Write a Review

NPPES record last updated: January 12, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Albert C Broders Iii Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALBERT C BRODERS III MD (NPI 1699721415) is an individual emergency medicine provider in Dallas, Texas, licensed in Texas (E3655) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1699721415
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameALBERT C BRODERS IIICredential: MD
Location Address8200 WALNUT HILL LNDallas, TX 75231-4426
Mailing AddressPo Box 8549Fort Worth, TX 76124-0549 · (817) 451-4208 · Fax (817) 563-3699
Phone(214) 345-6789
Sole ProprietorNo
Enumeration DateMay 25, 2006
Last NPPES UpdateJanuary 12, 2013
✔ NPI 1699721415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in TX · E3655
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
8200 WALNUT HILL LN, Dallas, TX 75231
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Other Identifiers 5

Medicare UPINC13785TX
Other0092CLTX · Bcbs
Medicare PIN00106DTX
Medicaid136316006TX
Medicare PIN930064423TX

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, revalidation, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Albert C Broders Iii Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateTexasEnrollment IDO20071005000615Part A · HospitalDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MUPPIDI REHAB, PLLC
Physical Medicine & Rehabilitation
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (214) 345-6789
DR. JOYZELLE HEROD MCCREARY PH.D.
Psychologist (Clinical)
8200 WALNUT HILL LN, DEPARTMENT OF PSYCHIATRY
DALLAS, TX 75231
Dallas County (214) 345-7355
DR. TIMOTHY A. MOORE M.D.
Anesthesiology
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (214) 345-6148
LISA-ANN WUERMSER MD
Physical Medicine & Rehabilitation
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (763) 520-0453
DARREN IMPHEAN MD
Student in an Organized Health Care Education/Training Program
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (214) 345-6789
MRS. MEREDITH DOERRIES RATLIFF
Dietitian, Registered
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (214) 345-7413
DR. ZAID SHAH DO
Internal Medicine
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (817) 881-3127
DR. URSZULA BARBARA KELLEY M.D.
Psychiatry & Neurology (Psychiatry)
8200 WALNUT HILL LN
DALLAS, TX 75231
Dallas County (214) 345-7355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Albert Broders's NPI number?

The NPI number for Albert Broders is 1699721415. It was assigned to this individual provider in the NPPES registry on May 25, 2006.

Where is Albert Broders located?

Albert Broders practices at 8200 Walnut Hill Ln, Dallas, TX 75231. The listed phone number is (214) 345-6789.

What is Albert Broders's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Albert Broders enrolled in Medicare?

Yes. Albert Broders is registered in the Medicare PECOS enrollment system.

When is Albert Broders's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this provider (Texas, Hospital) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Albert Broders was last updated on January 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.