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General NPI Number Information
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NPI Number | 1770760928
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Entity Type | Organization
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Legal Business Name | ARLINGTON NEONATAL INTENSIVE CARE PA
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 800 W RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76012-2504
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Country | US
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Telephone | 817-548-6514
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 120967
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City | ARLINGTON
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State | TX
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Zip | 76012-0967
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Country | US
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Telephone |
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Fax | 817-548-6173
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT C TISDELL
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Credential |
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Telephone | 817-548-6514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G3859
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License Number State | TX
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