Individual
MR. BRENTON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 922-4650
(817) 922-4655
Mailing address
1400 8TH AVE, FORT WORTH, TX 76104-4110
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
908717
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1077858
TX
Other
Enumeration date
10/26/2021
Last updated
05/11/2022
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