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Individual

ERIC BASH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
Mailing address
200 W MAGNOLIA AVE STE 201, FORT WORTH, TX 76104-7657
(469) 583-0807

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13868
TX

Other

Enumeration date
03/19/2020
Last updated
09/14/2023
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