MEDICARE: THE FORT WORTH CLINIC PA

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	261Q00000X	Clinic/Center		TX

General Provider Information

NPI Number	:	1366442931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FORT WORTH CLINIC PA

Provider Business Mailing Address
First Line	:	909 9TH AVE
Second Line	:	STE 300
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3903
Country	:	US
Telephone Number	:	817-336-7191
Fax Number	:	817-332-3172

Provider Business Practice Location Address
First Line	:	909 9TH AVE
Second Line	:	STE 300
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3903
Country	:	US
Telephone Number	:	817-336-7191
Fax Number	:	817-332-3172

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	THOMAS HIGHFIELD
Credential	:
Telephone Number	:	817-336-7191

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	07/21/2022

Similar Medicare Providers

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Practice Location Address:

909 9TH AVE , STE 300
FORT WORTH, TX
76104-3903

Practice Phone: 817-336-7191
Practice Fax: 817-877-4015

1932100468 — CECILA KARL MD
Practice Location Address:

909 9TH AVE , STE 300
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76104-3903

Practice Phone: 817-336-7191
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1245213230 — DR. RHETT KEYSER FREDRIC MD
Practice Location Address:

909 9TH AVE , SUITE 402
FORT WORTH, TX
76104-3903

Practice Phone: 817-338-9291
Practice Fax: 817-335-2817

1447236708 — DR. EDWIN CHARLES AUGUSTAT M.D.
Practice Location Address:

909 9TH AVE , STE 401
FORT WORTH, TX
76104-3903

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1508844176 — CLAUDIO STRAUS LEHMANN M.D.
Practice Location Address:

909 9TH AVE , SUIE 300
FORT WORTH, TX
76104-3903

Practice Phone: 817-336-7191
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1518929918 — DR. JAMES F DUNN MD
Practice Location Address:

909 9TH AVE , SUITE 300
FORT WORTH, TX
76104-3903

Practice Phone: 817-336-7191
Practice Fax: 817-288-0617

Directions to “THE FORT WORTH CLINIC PA ” Practice Location

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