Individual
DR. ROSS TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3815 LISBON ST STE 200, FT WORTH, TX 76107-5673
(817) 989-1122
(817) 989-2072
Mailing address
3815 LISBON ST STE 200, FT WORTH, TX 76107-5673
(817) 989-1122
(817) 989-2072
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J0303
TX
2084P0804X
Child & Adolescent Psychiatry Physician
J0303
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000T42H2
—
TX
Enumeration date
10/20/2006
Last updated
02/10/2014
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