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APURVA A MODI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1250 8TH AVE, SUITE # 515, FORT WORTH, TX 76104-4124
(817) 922-9968
(817) 922-9762
Mailing address
1250 8TH AVE, SUITE # 515, FORT WORTH, TX 76104-4124
(817) 922-9968
(817) 922-9762

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
N9912
TX
207RI0008X
Hepatology Physician
N9912
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007208700
MD
05
285797101
TX
Enumeration date
06/06/2006
Last updated
07/29/2015
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