Individual
ADAM JOSEPH BRUNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
929 LIPSCOMB ST, FORT WORTH, TX 76104
(817) 926-2663
(817) 293-8860
Mailing address
929 LIPSCOMB ST, FORT WORTH, TX 76104
(817) 926-2663
(817) 293-8860
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07431
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA07431
MEDICAL BOARD LICENSE
TX
Enumeration date
06/02/2011
Last updated
01/28/2015
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