| Harold B.eudaly Jr., M.d.pa | |
|
6300 Ridglea Pl Suite 814 Fort Worth TX 76116-5704 | |
| (817) 763-0022 | |
| (817) 763-0027 |
| Full Name | Harold B.eudaly Jr., M.d.pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 6300 Ridglea Pl, Fort Worth, Texas |
| Authorized Official Name and Position | Harold B Eudaly (OWNER) |
| Authorized Official Contact | 8177630022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harold B.eudaly Jr., M.d.pa 6300 Ridglea Place Suite 814 Fort Worth TX 76116-5704 Ph: (817) 763-0022 | Harold B.eudaly Jr., M.d.pa 6300 Ridglea Pl Suite 814 Fort Worth TX 76116-5704 Ph: (817) 763-0022 |
| NPI Number | 1811131758 |
|---|---|
| Provider Enumeration Date | 04/22/2009 |
| Last Update Date | 04/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811131758 | NPI | - | NPPES |
| 1881792026 | Other | OLD NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | C6930 (Texas) | Primary |
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