Organization
FEDERAL BUREAU OF PRISONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIO MONCADA MD (CLINICAL DIRECTOR)
(817) 782-4001
Entity
Organization
Contact information
Practice address
J STREET, BLDG 3000, FMC CARSWELL, FORT WORTH, TX 76127-7066
(817) 782-4001
(817) 782-4674
Mailing address
J STREET, BLDG 3000, FMC CARSWELL, FORT WORTH, TX 76127-7066
(817) 782-4001
(817) 782-4674
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
J9175
TX
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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