# UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659473056
- **Legal business name:** UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
- **Authorized official:** LESLIE HENDERSON (REVENUE CYCLE DIRECTOR)
- **Authorized official phone:** (817) 735-2008

## Contact information

- **Practice address:** 1307 8TH AVE STE 403, FORT WORTH, TX 76104-4143
- **Practice address phone:** (682) 207-1375
- **Practice address fax:** (682) 207-1377
- **Mailing address:** PO BOX 99335, FORT WORTH, TX 76199-0335
- **Mailing address phone:** (817) 735-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 09/05/2006
- **Last updated:** 12/16/2019