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Organization
HIGHWAY 30 FAMILY MEDICAL CENTER, PA
Active
Organization
HIGHWAY 30 FAMILY MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D HOFFMAN DO (OWNER/PHYSICIAN)
81742983000
Entity
Organization
Contact information
Practice address
1200 WOODHAVEN BLVD, FORT WORTH, TX 76112-2376
(817) 429-8300
(817) 429-6167
Mailing address
9991 MARSH LN, DALLAS, TX 75220-1766
(214) 358-0090
(214) 526-6851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153458801
—
TX
05
—
153458802
—
TX
Enumeration date
05/02/2006
Last updated
04/09/2012
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