Organization
LEGACY HEART CARE OF FORT WORTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRATCH (PRESIDENT)
(817) 423-4400
Entity
Organization
Contact information
Practice address
2500 WEST FWY, SUITE 200, FORT WORTH, TX 76102-5848
(817) 423-4400
(817) 423-8080
Mailing address
2500 WEST FWY, SUITE 200, FORT WORTH, TX 76102-5848
(817) 423-4400
(817) 423-8080
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
PA02558
TX
Other
Enumeration date
07/24/2008
Last updated
11/02/2022
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