Healthcare Provider Details

I. General information

NPI: 1801968920
Provider Name (Legal Business Name): HARRY MERIWETHER STIMMEL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 SYCAMORE SCHOOL RD
FORT WORTH TX
76133
US

IV. Provider business mailing address

3050 SYCAMORE SCHOOL RD
FORT WORTH TX
76133
US

V. Phone/Fax

Practice location:
  • Phone: 817-370-0021
  • Fax: 817-370-9457
Mailing address:
  • Phone: 817-370-0021
  • Fax: 817-370-9457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14439
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: