| University Of North Texas Health Science Center At Fort Worth | |
|
855 Montgomery St Fort Worth TX 76107 | |
| (817) 735-2000 | |
| Not Available |
| Full Name | University Of North Texas Health Science Center At Fort Worth |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 855 Montgomery St, Fort Worth, Texas |
| Authorized Official Name and Position | Leslie Henderson (REVENUE CYCLE DIRECTOR) |
| Authorized Official Contact | 8177352008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of North Texas Health Science Center At Fort Worth Po Box 99335 Fort Worth TX 76199-0335 Ph: (817) 735-2000 | University Of North Texas Health Science Center At Fort Worth 855 Montgomery St Fort Worth TX 76107 Ph: (817) 735-2000 |
| NPI Number | 1144328634 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 06/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144328634 | NPI | - | NPPES |
| 138980110 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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