Healthcare Provider Details

I. General information

NPI: 1780637983
Provider Name (Legal Business Name): ROBERT ALAN KAUFMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MISTLETOE BLVD
FORT WORTH TX
76104-4062
US

IV. Provider business mailing address

1800 MISTLETOE BLVD
FORT WORTH TX
76104-4062
US

V. Phone/Fax

Practice location:
  • Phone: 817-348-8145
  • Fax: 817-348-8264
Mailing address:
  • Phone: 817-348-8145
  • Fax: 817-348-8264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMO125
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: