MEDICARE: FORT WORTH WOMAN'S CLINIC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1386814374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT WORTH WOMAN'S CLINIC

Provider Business Mailing Address
First Line	:	6100 HARRIS PKWY STE 200
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4131
Country	:	US
Telephone Number	:	817-324-5252
Fax Number	:	817-370-2288

Provider Business Practice Location Address
First Line	:	6100 HARRIS PKWY STE 200
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4131
Country	:	US
Telephone Number	:	817-324-5252
Fax Number	:	817-370-2288

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	DR. DONNA C. KOLAR
Credential	:	M.D.
Telephone Number	:	817-346-5252

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	03/05/2008

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Directions to “FORT WORTH WOMAN'S CLINIC ” Practice Location

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