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General NPI Number Information
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NPI Number | 1689633430
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Entity Type | Organization
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Legal Business Name | FORT WORTH ORTHOPEDIC SURGERY & SPORTS MEDICINE, P.A.
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 3625 CAMP BOWIE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76107-3351
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Country | US
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Telephone | 817-737-8880
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Fax | 817-731-9112
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Provider Business Mailing Address
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Address Line | 3625 CAMP BOWIE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76107-3351
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Country | US
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Telephone | 817-737-8880
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Fax | 817-731-9112
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Authorized Official
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Title or Position | PRESIDEN
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Name | DR. CHRISTOPHER K HULL
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Credential | D.O.
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Telephone | 817-737-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | F4102
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License Number State | TX
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