Organization
TEXAS HEALTH CARE, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D. TATUM M.D. (C.E.O.)
(817) 740-8400
Entity
Organization
Contact information
Practice address
413 W. ROSEDALE, FORT WORTH, TX 76104-4808
(817) 348-8082
(817) 348-8772
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155109501
—
TX
Enumeration date
12/29/2006
Last updated
10/15/2011
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