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General NPI Number Information
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NPI Number | 1083945414
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Entity Type | Organization
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Legal Business Name | OSTEOPODS, PLLC
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 800 W MAGNOLIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4611
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Country | US
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Telephone | 817-313-4616
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Fax | 817-333-0173
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Provider Business Mailing Address
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Address Line | PO BOX 100937
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City | FORT WORTH
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State | TX
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Zip | 76185-0937
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Country | US
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Telephone | 817-313-4616
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Fax | 817-333-0173
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SAM W. BUCHANAN JR.
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Credential | DO
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Telephone | 817-313-4616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | E4229
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License Number State | TX
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