Individual
DR. FERNANDO SAN MIGUEL ANGELES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11803 S INTERSTATE 35W, SUITE 354, FORT WORTH, TX 76115-0000
(817) 293-9140
(817) 293-2392
Mailing address
8808 RACQUET CLUB DR, FORT WORTH, TX 76120-2836
(817) 861-3147
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E7800
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032272902
—
TX
Enumeration date
06/12/2006
Last updated
11/05/2012
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