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Self Richard Dba
Private Vehicle in Fort Worth, Texas
NPI 1003062472

Self Richard Dba is a Private Vehicle based in Fort Worth, TX. Self Richard Dba practices in Fort Worth, TX. The NPI Number for Self Richard Dba is 1003062472 and holds a License No. 09332825 (Texas).

The current practice location address for Self Richard Dba is 6701 Calmont Ave Apt 101, Fort Worth, TX and can be reached out via phone at 817-304-2892 and via fax at 817-246-4764.

Location: 6701 Calmont Ave Apt 101, Fort Worth, TX, 76116-4239
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1003062472
Provider Name
Self Richard Dba
Credential
Provider Entity Type
Organization
Address
6701 Calmont Ave Apt 101, Fort Worth, TX, 76116-4239
Phone Number
817-304-2892
Fax Number
817-246-4764
Provider Enumeration Date
08/17/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6701 Calmont Ave Apt 101
City
Fort Worth
State
Texas
Zip
76116-4239
Phone Number
817-304-2892
Fax Number
817-246-4764
person
Provider Business Mailing Address Details
Address
6701 Calmont Ave Apt 101
City
Fort Worth
State
Texas
Zip
76116-4239
Phone Number
817-304-2892
Fax Number
817-246-4764
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
09332825 (Texas)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
person
Provider's Taxonomy Details 2
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
09332825 (Texas)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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