Individual
JOHN T. ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
904 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2225
(817) 332-8817
(817) 332-8827
Mailing address
904 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2225
(817) 332-8817
(817) 332-8827
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
50455
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015311-0202
SECUREHORIZONS
TX
01
—
015430-0111
PACIFICARE
TX
01
—
01726
NECP, HEAR USA
TX
01
—
0616049
AETNA
TX
01
—
2313884
UNITED HEALTHCARE
TX
01
—
4189557
CHESAPEAKE LIFE
TX
01
—
514030
BCBS DIAG
TX
01
—
519929
BCBS DME
TX
Enumeration date
08/09/2005
Last updated
12/20/2007
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