Organization
FORT WORTH DERMATOLOGY ASSOCIATES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DOUGLAS MABERRY MD (OWNER)
(817) 336-8131
Entity
Organization
Contact information
Practice address
1200 W ROSEDALE ST, FORT WORTH, TX 76104-4454
(817) 336-8131
Mailing address
1200 W ROSEDALE ST, FORT WORTH, TX 76104-4454
(817) 336-8131
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
C8359
TX
Other
Enumeration date
08/20/2006
Last updated
02/09/2010
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