OrganizationActive
Brilliant Medical Boutique LLC
NPI 1497793830 · Durable Medical Equipment & Medical Supplies · Weatherford, TX
Provider details
- NPI number
- 1497793830
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Jamie Mittendorf, Owner and Operator(817) 594-5868
Specialties & taxonomies
Suppliers
- Prosthetic/Orthotic Supplier335E00000X
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
925 Santa Fe Dr
Suite 100
Weatherford, TX 76086-5866
Phone: (817) 594-5868
Fax: (817) 594-5833
Street-level locationGet directions
Mailing address
925 Santa Fe Dr
Weatherford, TX 76086-5866
Registry dates
- Enumerated
- 2006-06-04
- Last updated
- 2022-09-08
- Certified
- 2022-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.