Organization
FORT WORTH PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VISHNU ILINENI MD (OWNER)
(203) 224-8568
Entity
Organization
Contact information
Practice address
6201 OVERTON RIDGE BLVD, FORT WORTH, TX 76132-3613
(203) 224-8568
Mailing address
400 MONTPELIER DR, SOUTHLAKE, TX 76092-1335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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