Organization
MICHAEL E TRUMAN DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E TRUMAN D.O. (OWNER)
(817) 446-5500
Entity
Organization
Contact information
Practice address
2401 CANTON DR, FORT WORTH, TX 76112-5001
(817) 446-5500
(817) 446-5509
Mailing address
2401 CANTON DR, FORT WORTH, TX 76112-5001
(817) 446-5500
(817) 446-5509
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D8836
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0092RA
BLUE CROSS BLUE SHIELD
TX
05
—
122334903
—
TX
Enumeration date
11/28/2007
Last updated
05/07/2008
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