Organization
MY1PHP
Active
Organization
MY1PHP
Active
Parent organization
FOUROAKSHEALTH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUROAKSHEALTH LLC
Authorized official
HARRY DONALD SPRING (MANAGING MEMBER)
(817) 875-8031
Entity
Organization
Contact information
Practice address
5131 BRYCE AVE, FORT WORTH, TX 76107-3611
(817) 875-8031
Mailing address
5131 BRYCE AVE, FORT WORTH, TX 76107-3611
(817) 875-8031
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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