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General NPI Number Information
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NPI Number | 1730247370
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Entity Type | Organization
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Legal Business Name | SANUS HEALTHCARE INC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 W CENTRAL AVE SUITE 200
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City | FORT WORTH
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State | TX
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Zip | 76106-9131
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Country | US
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Telephone | 817-626-9400
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Fax | 817-626-9402
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Provider Business Mailing Address
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Address Line | 301 W CENTRAL AVE SUITE 200
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City | FORT WORTH
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State | TX
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Zip | 76106-9131
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Country | US
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Telephone | 817-626-9400
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Fax | 817-626-9402
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HECTOR O MOLINA
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Credential | MD
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Telephone | 214-850-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K2755
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License Number State | TX
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