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Organization
TEXAS HEART CLINIC PA
Active
Organization
TEXAS HEART CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEF WIDERHORN MD (PHYSICIAN OWNER)
(817) 922-9050
Entity
Organization
Contact information
Practice address
1307 8TH AVE, SUITE 501, FORT WORTH, TX 76104
(817) 922-9050
Mailing address
PO BOX 12229, FORT WORTH, TX 76110-8229
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
J2843
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
J2843
TX
207RI0011X
Interventional Cardiology Physician
J2843
TX
Other
Enumeration date
10/16/2006
Last updated
06/16/2008
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