Organization
KENNETH WAYNE MORRIS
Active
Other names
Physiologics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH WAYNE MORRIS (OWNER)
(817) 237-8429
Entity
Organization
Contact information
Practice address
4707 ALWOOD CT, FORT WORTH, TX 76135-1901
(817) 237-8429
(817) 237-8583
Mailing address
PO BOX 136372, FORT WORTH, TX 76136-0372
(817) 237-8429
(817) 237-8583
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z0PL03320
—
TX
Enumeration date
12/28/2006
Last updated
08/22/2020
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