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General NPI Number Information
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NPI Number | 1124323191
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Entity Type | Organization
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Legal Business Name | TARRANT COUNTY PUBLIC HEALTH DEPT.
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 1101 S MAIN ST #1600
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City | FT WORTH
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State | TX
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Zip | 76104-4802
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Country | US
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Telephone | 817-321-4934
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Fax | 817-321-4920
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Provider Business Mailing Address
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Address Line | 1101 S MAIN ST #1600
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City | FT WORTH
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State | TX
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Zip | 76104-4802
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Country | US
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Telephone | 817-321-4934
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Fax | 817-321-4920
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Authorized Official
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Title or Position | LVN
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Name | ANITA KAYE ELLENBERGER
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Credential | LVN
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Telephone | 817-321-4934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 74925
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License Number State | TX
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