Individual
BO B WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2400
(817) 735-0615
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2400
(817) 735-0615
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M6961
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188782001
—
TX
01
—
8X5111
BCBS
TX
01
—
P00770579
RAILROAD MEDICARE
TX
Enumeration date
05/14/2007
Last updated
09/27/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us