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Fort Worth Proctologic Clinic, Pa
Specialist in Fort Worth, Texas
NPI 1710217435

Fort Worth Proctologic Clinic, Pa is a Specialist based in Fort Worth, TX. Fort Worth Proctologic Clinic, Pa practices in Fort Worth, TX. The NPI Number for Fort Worth Proctologic Clinic, Pa is 1710217435 and holds a License No. E1124 (Texas).

The current practice location address for Fort Worth Proctologic Clinic, Pa is 1050 W Rosedale St, Fort Worth, TX and can be reached out via phone at 817-338-4501 and via fax at 817-338-4503.

Location: 1050 W Rosedale St, Fort Worth, TX, 76104-4422
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1710217435
Provider Name
Fort Worth Proctologic Clinic, Pa
Credential
Provider Entity Type
Organization
Address
1050 W Rosedale St, Fort Worth, TX, 76104-4422
Phone Number
817-338-4501
Fax Number
817-338-4503
Provider Enumeration Date
12/31/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
099907001 05 TX
institution
Provider Business Practice Location Address Details
Address
1050 W Rosedale St
City
Fort Worth
State
Texas
Zip
76104-4422
Phone Number
817-338-4501
Fax Number
817-338-4503
person
Provider Business Mailing Address Details
Address
1050 W Rosedale St
City
Fort Worth
State
Texas
Zip
76104-4422
Phone Number
817-338-4501
Fax Number
817-338-4503
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
E1124 (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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