Healthcare Provider Details

I. General information

NPI: 1619389392
Provider Name (Legal Business Name): THOMAS FIKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 05/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8216 DEERWOOD FOREST DR
FORT WORTH TX
76126-5181
US

IV. Provider business mailing address

8216 DEERWOOD FOREST DR
FORT WORTH TX
76126-5181
US

V. Phone/Fax

Practice location:
  • Phone: 817-946-1802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberF9418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: