NPI age
19 years
Enumerated 2006-06-04
● Active Type 2 · Organization
Brilliant Medical Boutique Llc
Brilliant Medical Boutique Llc is 1 of 6200 durable medical equipment & medical supplies organizations in Texas.
Primary specialty
Durable Medical Equipment & Medical Supplies
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Mittendorf
Owner And Operator
Last NPPES update
2022-09-08
Source: monthly bulk 2026-05
How this organization compares
Across 6200 active durable medical equipment & medical supplies providers in Texas.
NPI age
19 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 15% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
925 Santa Fe Dr, Suite 100
Weatherford, TX 760865866
Mailing address
925 Santa Fe Dr, Suite 100
Weatherford, TX 760865866
Authorized official
Jamie B. Mittendorf
Owner And Operator
📞 8175945868
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Nancy Powell, CRNA Nurse Anesthetist, Certified Registered NPI 1336167469
- Caleb Sawyer, M.D. Ophthalmology NPI 1568482578
- Rita Turns, OTR Occupational Therapist NPI 1548476468
- Tina Wofford, SAC Licensed Vocational Nurse NPI 1013127083
Specialties
-
Durable Medical Equipment & Medical Supplies PrimaryA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
-
Prosthetic/Orthotic SupplierAn organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 178601402 |
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.