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Individual

DR. KENNETH AARON MAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2000 COOPER ST STE 120, FORT WORTH, TX 76104-2535
(817) 820-2890
(817) 810-0725
Mailing address
2000 COOPER ST STE 560, FORT WORTH, TX 76104-2528
(817) 820-2890
(817) 810-0725

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J1541
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
J1541
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0045BY
BCBS TEXAS/ MEDICARE GROUP #
TX
05
080636601
TX
05
101561202
TX
01
88820F
BCBS TEXAS/ MEDICARE INDIVIDUAL #
TX
Enumeration date
07/07/2006
Last updated
11/05/2025
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