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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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