Organization
FORT WORTH DERMATOLOGY CENTER, PLLC
Active
Organization
FORT WORTH DERMATOLOGY CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN JERRY CARROLL MD (PHYSICIAN, PARTNER)
(956) 740-8650
Entity
Organization
Contact information
Practice address
6900 HARRIS PKWY, SUITE 200, FORT WORTH, TX 76132-4255
(956) 740-8650
Mailing address
6900 HARRIS PKWY, SUITE 200, FORT WORTH, TX 76132-4255
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
Q6500
TX
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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