Individual
DR. JOSEF WIDERHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1307 8TH AVE STE 501, FORT WORTH, TX 76104-4143
(817) 922-9050
Mailing address
PO BOX 12229, FORT WORTH, TX 76110-8229
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J2843
TX
207RC0000X
Cardiovascular Disease Physician
Primary
J2843
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
J2843
TX
207RI0011X
Interventional Cardiology Physician
J2843
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171076
ATNA HMO
TX
01
—
2500101
UNITED HEALTHCARE
TX
01
—
2837065-007
CIGNA PPO
TX
01
—
2837065-012
CIGNA HMO
TX
01
—
4236959
AETNA PPO
TX
01
—
60055861
RAILROAD MEDICARE
TX
01
—
80420Y
BLUE CROSS BLUE SHIELD
TX
01
—
85K247
BLUE CROSS (HARRIS HOSP)
TX
01
—
E51105
TRICARE (HARRIS HOSP)
TX
Enumeration date
08/08/2007
Last updated
04/02/2008
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