| Texas Health Care, P.l.l.c. | |
|
1307 8th Ave Suite 610 Fort Worth TX 76104-4142 | |
| (817) 924-6200 | |
| (817) 924-6201 |
| Full Name | Texas Health Care, P.l.l.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1307 8th Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Larry D. Tatum (C.E.O.) |
| Authorized Official Contact | 8177408400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Health Care, P.l.l.c. Po Box 961205 Fort Worth TX 76161-1205 Ph: (817) 740-8400 | Texas Health Care, P.l.l.c. 1307 8th Ave Suite 610 Fort Worth TX 76104-4142 Ph: (817) 924-6200 |
| NPI Number | 1558427724 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 10/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558427724 | NPI | - | NPPES |
| 155109501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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