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ORTHOPEDICS TODAY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL BOOTHBY (OWNER)
(817) 529-1900
Entity
Organization

Contact information

Practice address
6049 S HULEN ST, 100, FORT WORTH, TX 76132-4815
(817) 529-1900
Mailing address
6049 S HULEN ST, 100, FORT WORTH, TX 76132-4815
(817) 529-1900

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
TX

Other

Enumeration date
11/21/2013
Last updated
11/21/2013
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