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Organization
JPS PHYSICIAN GROUP, INC
Active
Organization
JPS PHYSICIAN GROUP, INC
Active
Other names
Southwest Sports and Spine Center
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JOHNSON (DIRECTOR OF OPERATIONS)
(817) 920-3887
Entity
Organization
Contact information
Practice address
1617 HEMPHILL ST, FORT WORTH, TX 76104-4709
(817) 920-6245
Mailing address
7148 TRAIL LAKE DR, FORT WORTH, TX 76123-1969
(817) 920-6245
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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