Organization
TARRANT COUNTY INFECTIOUS DISEASE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM DUNAJ (PRACTICE ADMINISTRATOR)
(817) 810-9810
Entity
Organization
Contact information
Practice address
1025 COLLEGE AVE, FORT WORTH, TX 76104-3013
(817) 348-0821
(817) 348-0073
Mailing address
1025 COLLEGE AVE, FORT WORTH, TX 76104-3013
(817) 810-9810
(817) 810-9815
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00099K
BCBS GROUP
TX
01
—
CH8204
MEDICARE RR GROUP
—
Enumeration date
06/07/2010
Last updated
09/30/2019
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