Organization
UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER OF FORT WORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE HENDERSON (REVENUE CYCLE DIRECTOR)
(817) 735-2008
Entity
Organization
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107
(817) 735-2000
Mailing address
3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107-2644
(817) 735-2000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138980112
—
TX
Enumeration date
09/11/2007
Last updated
06/06/2018
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