MEDICARE: FEMALE HEALTH ASSOCIATES OF NORTH TEXAS PLLC

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
1	207V00000X	Obstetrics & Gynecology Physician	K7757	TX

General Provider Information

NPI Number	:	1447638622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEMALE HEALTH ASSOCIATES OF NORTH TEXAS PLLC

Provider Business Mailing Address
First Line	:	1327 HEMPHILL ST
Second Line	:	SUITE 100
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4735
Country	:	US
Telephone Number	:	817-731-3936
Fax Number	:	817-782-0206

Provider Business Practice Location Address
First Line	:	1327 HEMPHILL ST
Second Line	:	SUITE 100
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4735
Country	:	US
Telephone Number	:	817-731-3936
Fax Number	:	817-782-0206

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY M HANTES
Credential	:	DO
Telephone Number	:	817-731-3936

Provider Enumeration Date	:	05/08/2015
Last Update Date	:	05/08/2015

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