Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Brilliant Medical Boutique, LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1770751950

Brilliant Medical Boutique, LLC is a Durable Medical Equipment & Medical Supplies in Fort Worth, Texas. Licensed in Tennessee. Registered with an NPI since 2008.

Licensed in
TN
In the registry since
2008
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6800 Harris Pkwy Ste 300
Fort Worth, TX 76132-4262
Phone: (682) 312-9300
Fax: (682) 312-9133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X
Prosthetic/Orthotic Supplier Taxonomy 335E00000X · Licence CFM01117 (TN)

Record details

NPI number1770751950
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamie Mittendorf — Owner · (817) 594-5868
NPI enumeratedFebruary 11, 2008
Last updated in NPPESSeptember 8, 2022
Certification dateSeptember 8, 2022
Mailing address6800 Harris Pkwy Ste 300, Fort Worth, TX 76132-4262

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