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General NPI Number Information
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NPI Number | 1083799209
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Entity Type | Organization
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Legal Business Name | CHIRONET, L.L.C.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 3149 LACKLAND RD #104
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City | FORT WORTH
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State | TX
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Zip | 76116-4109
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Country | US
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Telephone | 817-886-8890
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Fax | 817-886-8891
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Provider Business Mailing Address
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Address Line | 3149 LACKLAND RD #104
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City | FORT WORTH
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State | TX
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Zip | 76116-4109
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Country | US
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Telephone | 817-886-8890
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Fax | 817-886-8891
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VAN A. HARTNITT
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Credential |
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Telephone | 817-886-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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