Individual
JOHN P KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2900
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05284
TX
363AS0400X
Surgical Physician Assistant
PA05284
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351426701
—
TX
01
—
8986NR
BCBS
TX
Enumeration date
07/30/2007
Last updated
01/26/2016
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