Healthcare Provider Details

I. General information

NPI: 1982251708
Provider Name (Legal Business Name): CARLA TABBS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3912 N TARRANT PKWY STE 200
FORT WORTH TX
76244-5413
US

IV. Provider business mailing address

3912 N TARRANT PKWY STE 200
FORT WORTH TX
76244-5413
US

V. Phone/Fax

Practice location:
  • Phone: 817-431-4471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLA R TABBS
Title or Position: OWNER
Credential: MD
Phone: 817-437-4471