MEDICARE: MICHAEL ROSS M.D.

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	207RH0003X	Hematology & Oncology Physician	F5349	TX

General Provider Information

NPI Number	:	1821048323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ROSS M.D.

Provider Business Mailing Address
First Line	:	800 W MAGNOLIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD STE 102
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2084
Country	:	US
Telephone Number	:	817-759-7000
Fax Number	:	817-759-7027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	02/05/2025

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