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General NPI Number Information
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NPI Number | 1912063371
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Entity Type | Organization
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Legal Business Name | TEXAS HEALTH CARE, P.L.L.C.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 4760 BARWICK DRIVE, SUITE C
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City | FORT WORTH
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State | TX
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Zip | 76132-1529
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Country | US
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Telephone | 817-346-9533
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Fax | 817-346-9788
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Provider Business Mailing Address
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Address Line | P.O. BOX 961205
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City | FORT WORTH
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State | TX
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Zip | 76161-1205
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Country | US
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Telephone | 817-740-8400
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Fax | 817-378-3699
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Authorized Official
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Title or Position | C.E.O.
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Name | LARRY D. TATUM
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Credential | M.D.
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Telephone | 817-740-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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