Healthcare Provider Details

I. General information

NPI: 1538292990
Provider Name (Legal Business Name): TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PENNSYLVANIA AVE
FORT WORTH TX
76104-2122
US

IV. Provider business mailing address

500 E BORDER ST
ARLINGTON TX
76010-7445
US

V. Phone/Fax

Practice location:
  • Phone: 817-882-2000
  • Fax: 817-570-8199
Mailing address:
  • Phone: 817-570-8500
  • Fax: 682-236-4620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number000235
License Number StateTX

VIII. Authorized Official

Name: MRS. LILLIE BIGGINS
Title or Position: PRESIDENT HMFW, EVP THR
Credential:
Phone: 817-882-3770