Individual
GARY VICTOR BARTHOLOMEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5450 CLEARFORK MAIN ST STE 220, FORT WORTH, TX 76109-3562
(817) 505-0233
(817) 332-3172
Mailing address
5450 CLEARFORK MAIN ST STE 410, FORT WORTH, TX 76109-3559
(817) 505-0233
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
926
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0187254-01
—
TX
05
—
018725402
—
TX
01
—
084933301
MEDICAID GROUP NUMBER
TX
Enumeration date
03/06/2007
Last updated
10/22/2019
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