Organization
FORT WORTH CARDIOVASCULAR CENTER, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY M FLANEGIN III (PRESIDENT)
(610) 831-1112
Entity
Organization
Contact information
Practice address
1650 W ROSEDALE ST, SUITE 206, FORT WORTH, TX 76104-7400
(817) 877-0052
(817) 877-4103
Mailing address
7 WATERSIDE XING, 3RD FLOOR ATTN: KAREN FRISK, CONTRACTING, WINDSOR, CT 06095-1540
(800) 367-1095
(860) 298-6127
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
L04659
TX
Other
Enumeration date
05/19/2006
Last updated
08/31/2007
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