Organization
TEXAS HEALTH CARE, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D. TATUM MD (CEO)
(817) 740-8400
Entity
Organization
Contact information
Practice address
923 PENNSYLVANIA AVE STE 200, FORT WORTH, TX 76104-2254
(817) 920-0484
(817) 920-0068
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155109501
—
TX
Enumeration date
11/26/2012
Last updated
11/26/2012
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