Individual
AMELIA BROOKE TOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1300 W TERRELL AVE STE 420, FORT WORTH, TX 76104-2810
(817) 250-6570
Mailing address
1300 W TERRELL AVE STE 420, FORT WORTH, TX 76104-2810
(817) 250-6570
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
OS016537
PA
208600000X
Surgery Physician
Q0374
TX
2086X0206X
Surgical Oncology Physician
Primary
Q0374
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335786501
—
TX
05
—
335786503
—
TX
01
—
8EJ304
BCBS
TX
Enumeration date
07/08/2013
Last updated
07/21/2022
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