Individual
GERARDO AMEZCUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-8840
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-8840
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
V0339
TX
Other
Enumeration date
03/30/2022
Last updated
06/06/2024
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