Organization
UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
Active
Parent organization
UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
Authorized official
LESLIE HENDERSON (REVENUE CYCLE DIRECTOR)
(817) 735-2008
Entity
Organization
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107
(817) 735-2000
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138980116
—
TX
Enumeration date
09/13/2006
Last updated
06/06/2018
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