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NPI Code Detail

MEDICARE: BELINDA TATUM

MEDICARE:   BELINDA  TATUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse185905TX

General Provider Information

NPI Number : 1205300811
Entity Type Code : Individual
Provider Name (Legal Business Name) : BELINDA TATUM
Provider Business Mailing Address
First Line : 591 HCR 1425
Second Line :
City : COVINGTON
State : TX
Zip : 76636
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6115 CAMP BOWIE BLVD STE 290
Second Line :
City : FT WORTH
State : TX
Zip : 76116-5500
Country : US
Telephone Number : 817-831-1105
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2019
Last Update Date : 01/16/2019

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Directions to “ BELINDA TATUM ” Practice Location

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