Organization
CTPC FORT WORTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL FREDERICK MD (MD/OWNER)
(512) 485-7208
Entity
Organization
Contact information
Practice address
7235 BOAT CLUB RD, FORT WORTH, TX 76179-4555
(817) 573-9800
(817) 573-9821
Mailing address
PO BOX 208357, DALLAS, TX 75320-8354
(512) 485-7208
(844) 364-8678
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
09/11/2020
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