Organization
TEXAS HEALTH CARE, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D. TATUM M.D. (C.E.O.)
(817) 740-8400
Entity
Organization
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 400, FORT WORTH, TX 76104-2128
(817) 250-5900
(817) 250-5901
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155109501
—
TX
01
—
45D0485973
CLIA
—
Enumeration date
03/17/2010
Last updated
03/17/2010
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