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General NPI Number Information
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NPI Number | 1003018490
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Entity Type | Organization
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Legal Business Name | PHYSICIANS FAMILY PRACTICE ASSOCIATES
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 5701 BRYANT IRVIN RD SUITE 203
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City | FORT WORTH
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State | TX
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Zip | 76132-4029
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Country | US
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Telephone | 817-346-4000
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Fax | 817-263-9398
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Provider Business Mailing Address
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Address Line | 5701 BRYANT IRVIN RD SUITE 203
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City | FORT WORTH
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State | TX
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Zip | 76132-4029
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Country | US
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Telephone | 817-346-4000
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Fax | 817-263-9398
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Authorized Official
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Title or Position | DR
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Name | DR. JAMES RICHARD BOHNSACK
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Credential | M.D.
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Telephone | 817-346-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F1396
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License Number State | TX
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