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Individual

JOSEPH DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
6311 SOUTHWEST BLVD, FORT WORTH, TX 76132-1063
(817) 731-9400
(817) 731-4282
Mailing address
6311 SOUTHWEST BLVD, BENBROOK, TX 76132-1063
(817) 731-9400
(817) 731-4282

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H4822
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0078NR
BCBS GROUP#
TX
01
10028628
AMERIGROUP MEDICAID
05
11455304 301
TX
05
114855305
TX
01
3108265
AETNA
01
360057000
DEPARTMENT OF LABOR
01
364523608
TRICARE
01
8V9721
BCBS INDIVIDUAL
01
900057614
MEDICARE RR
Enumeration date
05/31/2006
Last updated
02/15/2017
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