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NPI Code Detail

MEDICARE: FORT WORTH ENDOSCOPY CENTERS, LLC

MEDICARE: FORT WORTH ENDOSCOPY CENTERS, LLC
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1538104724
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORT WORTH ENDOSCOPY CENTERS, LLC
Provider Business Mailing Address
First Line : 6445 HARRIS PKWY
Second Line : STE 150
City : FORT WORTH
State : TX
Zip : 76132-4138
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6445 HARRIS PKWY STE 150
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4140
Country : US
Telephone Number : 817-423-2888
Fax Number :
Authorized Official
Title or Position : VP
Name : RICHARD L SHARFF JR.
Credential :
Telephone Number : 205-545-2572
Provider Enumeration Date : 06/19/2006
Last Update Date : 12/31/2015

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Directions to “FORT WORTH ENDOSCOPY CENTERS, LLC ” Practice Location

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