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Fort Worth Ent,p.a.
Specialist in Fort Worth, Texas
NPI 1336353366

Fort Worth Ent,p.a. is a Specialist based in Fort Worth, TX. Fort Worth Ent,p.a. practices in Fort Worth, TX. The NPI Number for Fort Worth Ent,p.a. is 1336353366 and holds a License No. H2007 (Texas).

The current practice location address for Fort Worth Ent,p.a. is 1250 8Th Ave, Fort Worth, TX and can be reached out via phone at 817-335-8151 and via fax at 817-335-2670.

Location: 1250 8Th Ave, Fort Worth, TX, 76104
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336353366
Provider Name
Fort Worth Ent,p.a.
Credential
Provider Entity Type
Organization
Address
1250 8Th Ave, Fort Worth, TX, 76104
Phone Number
817-335-8151
Fax Number
817-335-2670
Provider Enumeration Date
05/09/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8G2131 01 TX TODD E. SAMUELSON MD BCBS
031074002 05 TX
166927701 05 TX
H2007 01 TX TODD E SAMUELSON MD LICEN
institution
Provider Business Practice Location Address Details
Address
1250 8Th Ave
City
Fort Worth
State
Texas
Zip
76104
Phone Number
817-335-8151
Fax Number
817-335-2670
person
Provider Business Mailing Address Details
Address
1250 8Th Ave
City
Fort Worth
State
Texas
Zip
76104
Phone Number
817-335-8151
Fax Number
817-335-2670
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
H2007 (Texas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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