Individual
BRIAN BORDELON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9701 HARMON RD STE 141, FORT WORTH, TX 76177-7602
(817) 306-5630
(817) 306-5631
Mailing address
9701 HARMON RD STE 141, FORT WORTH, TX 76177-7602
(817) 306-5630
(817) 306-5631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T5266
TX
390200000X
Student in an Organized Health Care Education/Training Program
6950
OK
Other
Enumeration date
04/01/2019
Last updated
07/13/2022
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