# 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:** 1740397066
- **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:** 3500 CAMP BOWIE BOULEVARD, FORT WORTH, TX 76107
- **Practice address phone:** (817) 735-2000
- **Mailing address:** PO BOX 99335, FORT WORTH, TX 76199-0335
- **Mailing address phone:** (817) 735-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 06/06/2018