Organization
CENTRAL PARK EAR NOSE AND THROAT, LLP FORT WORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN E BLAKE J.D., CPA, MBA (C.E.O./ADMINISTRATOR)
(817) 261-9191
Entity
Organization
Contact information
Practice address
409 CENTRAL PARK DR, ARLINGTON, TX 76014-2069
(817) 261-9191
(817) 784-8301
Mailing address
800 8TH AVE, SUITE 618, FORT WORTH, TX 76104-2601
(817) 335-3366
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
10/25/2013
Last updated
10/25/2013
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