MEDICARE: TARRANT WOMENS HEALTH MEDICAL GROUP, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CG1422	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0064DJ	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1225187727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARRANT WOMENS HEALTH MEDICAL GROUP, P.A.

Provider Business Mailing Address
First Line	:	6100 HARRIS PKWY
Second Line	:	#140
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4131
Country	:	US
Telephone Number	:	817-346-5336
Fax Number	:	817-346-5366

Provider Business Practice Location Address
First Line	:	6100 HARRIS PKWY
Second Line	:	#140
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4131
Country	:	US
Telephone Number	:	817-346-5336
Fax Number	:	817-346-5366

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	KERRY APPLE
Credential	:
Telephone Number	:	817-346-5336

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	02/10/2009

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Directions to “TARRANT WOMENS HEALTH MEDICAL GROUP, P.A. ” Practice Location

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