Organization
TEXAS HEALTH CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D. TATUM M.D. (C.E.O.)
(817) 740-8400
Entity
Organization
Contact information
Practice address
1250 8TH AVENUE, SUITE 205, FORT WORTH, TX 76104-4158
(817) 335-8151
(817) 926-2531
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155109501
—
TX
Enumeration date
02/06/2012
Last updated
06/12/2012
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