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General NPI Number Information
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NPI Number | 1134426794
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Entity Type | Organization
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Legal Business Name | R TODD PLOTT MD PA
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 02/17/2011
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Provider Practice Location Address
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Address Line | 12469 TIMBERLAND BLVD
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City | FORT WORTH
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State | TX
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Zip | 76244
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Country | US
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Telephone | 817-993-0332
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Fax |
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Provider Business Mailing Address
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Address Line | 12469 TIMBERLAND BLVD
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City | FORT WORTH
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State | TX
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Zip | 76244
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Country | US
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Telephone | 817-993-0332
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | RONALD TODD PLOTT
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Credential | MD
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Telephone | 817-993-0332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | H8330
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License Number State | TX
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