Individual
COREY R SEGARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2400
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04889
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199957501
—
TX
05
—
199957508
—
TX
01
—
8539NF
BCBS
TX
01
—
P01527358
RAILROAD MEDICARE
TX
Enumeration date
06/19/2008
Last updated
02/05/2025
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