Individual
DR. GARY LEE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4020 EDGEHILL RD, FORT WORTH, TX 76116-7325
(817) 377-3352
Mailing address
4020 EDGEHILL RD, FORT WORTH, TX 76116-7325
(817) 377-3352
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
J6924
TX
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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