Healthcare Provider Details

I. General information

NPI: 1538177589
Provider Name (Legal Business Name): TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 HARRIS PKWY
FORT WORTH TX
76132-4101
US

IV. Provider business mailing address

500 E BORDER ST
ARLINGTON TX
76010-7445
US

V. Phone/Fax

Practice location:
  • Phone: 817-433-6565
  • Fax: 817-433-6574
Mailing address:
  • Phone: 817-570-8500
  • Fax: 682-236-4620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number000627
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number000627
License Number StateTX

VIII. Authorized Official

Name: MRS. CHARLOTTE WARD
Title or Position: VP, FINANCE
Credential:
Phone: 817-433-6565