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Organization

UROLOGY CONSULTANTS OF FORT WORTH LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SIDNEY A WORSHAM III M.D. (LIMITED PARTNER)
(817) 877-1288
Entity
Organization

Contact information

Practice address
800 8TH AVE, SUITE 626, FORT WORTH, TX 76104-2601
(817) 877-1288
(817) 877-5242
Mailing address
800 8TH AVE, SUITE 626, FORT WORTH, TX 76104-2601
(817) 877-1288
(817) 877-5242

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D8491
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0814303-01
TX
Enumeration date
06/14/2007
Last updated
01/05/2010
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