person
Timothy L Black, MD
Pediatric Surgery Physician in Fort Worth, Texas
NPI 1669453940

Timothy L Black is a Pediatric Surgery Physician based in Fort Worth, TX and is specialized in Pediatric Surgery. Timothy L Black practices in Fort Worth, TX and has the professional credentials of MD. The NPI Number for Timothy L Black is 1669453940 and holds a License No. H1467 (Texas).

The current practice location address for Timothy L Black is 1500 Cooper St, Fort Worth, TX and can be reached out via phone at 682-885-7080 and via fax at 682-885-7085.

Location: 1500 Cooper St, Fort Worth, TX, 76199-0371
person
Provider Profile Details
NPI Number
1669453940
Provider Name
Timothy L Black
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1500 Cooper St, Fort Worth, TX, 76199-0371
Phone Number
682-885-7080
Fax Number
682-885-7085
Provider Enumeration Date
11/14/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1750369203 01 NPI GROUP NUMBER
8G3393 01 TX BCBSTX PIN
117647108 05 TX
117647106 05 TX
institution
Provider Business Practice Location Address Details
Address
1500 Cooper St
City
State
Zip
76104-2710
Phone Number
682-885-7080
Fax Number
682-885-7085
person
Provider Business Mailing Address Details
Address
1500 Cooper St
City
State
Zip
76104-2710
Phone Number
682-885-7080
Fax Number
682-885-7085
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Pediatric Surgery
Taxonomy
License No.
H1467 (Texas)
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
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