Organization
J MARK BAYOUTH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BAYOUTH MD (OWNER)
(817) 727-2002
Entity
Organization
Contact information
Practice address
2600 ALEMEDA ST STE 202, FORT WORTH, TX 76108-4042
(817) 727-2022
Mailing address
4662 SANTA COVA CT, FORT WORTH, TX 76126-1939
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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