Organization
FORT WORTH HEALTHCARE SYSTEMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA L RILEY (ADMINSTRATOR)
(214) 943-9431
Entity
Organization
Contact information
Practice address
1002 MONTGOMERY ST, FORT WORTH, TX 76107-2693
(817) 377-4011
(817) 377-9269
Mailing address
PO BOX 3770, DALLAS, TX 75208-1070
(817) 377-4011
(817) 377-9269
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0041MA
BCBS
TX
Enumeration date
05/17/2006
Last updated
12/13/2011
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