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NPI Code Detail

MEDICARE: TEXAS HEALTH CARE, P.L.L.C.

MEDICARE: TEXAS HEALTH CARE, P.L.L.C.
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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1821641820
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS HEALTH CARE, P.L.L.C.
Provider Business Mailing Address
First Line : P.O. BOX 961205
Second Line :
City : FORT WORTH
State : TX
Zip : 76161-1205
Country : US
Telephone Number : 817-740-8400
Fax Number : 817-378-3699
Provider Business Practice Location Address
First Line : 2909 LACKLAND ROAD
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-4119
Country : US
Telephone Number : 817-740-8400
Fax Number :
Authorized Official
Title or Position : C.E.O.
Name : LARRY D TATUM
Credential : M.D.
Telephone Number : 817-740-8400
Provider Enumeration Date : 07/18/2019
Last Update Date : 07/18/2019

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Directions to “TEXAS HEALTH CARE, P.L.L.C. ” Practice Location

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