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General NPI Number Information
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NPI Number | 1548394679
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Entity Type | Organization
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Legal Business Name | MOTHERS' MILK BANK OF NORTH TEXAS, INC.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1300 W LANCASTER AVE SUITE 108
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City | FORT WORTH
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State | TX
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Zip | 76102-3410
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Country | US
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Telephone | 817-810-0071
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Fax | 817-810-0087
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Provider Business Mailing Address
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Address Line | 1300 W LANCASTER AVE SUITE 108
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City | FORT WORTH
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State | TX
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Zip | 76102-3410
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Country | US
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Telephone | 817-810-0071
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Fax | 817-810-0087
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Authorized Official
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Title or Position | PRESIDENT OF THE BOARD OF DIRESTORS
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Name | DR. SUSAN SWARD-COMUENLLI
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Credential | MD
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Telephone | 817-810-0071
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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