Individual
DAN THOMAS DAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 735-2228
(817) 735-2582
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2228
(817) 735-2582
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K7713
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038725001
—
TX
01
—
080159721
RAILROAD MEDICARE PIN
TX
01
—
87528G
BCBS
TX
Enumeration date
03/14/2006
Last updated
05/10/2011
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