Organization
TEXAS HEALTH CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D TATUM MD (CEO)
(817) 740-8400
Entity
Organization
Contact information
Practice address
508 S ADAMS ST STE 100, FORT WORTH, TX 76104-2151
(817) 332-5099
(817) 332-9093
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155109501
—
TX
01
—
45D0969321
CLIA
TX
Enumeration date
12/29/2006
Last updated
08/27/2015
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