Individual
MIGUEL TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5470 E LOOP 820, STE 110, FORT WORTH, TX 76119-6515
(817) 536-6877
(817) 535-5233
Mailing address
5470 E LOOP 820, STE 110, FORT WORTH, TX 76119-6515
(817) 536-6877
(817) 535-5233
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
11403
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010839101
—
TX
05
—
010839102
—
TX
05
—
016703301
—
TX
01
—
530531
BLUE CROSS BLUE SHIELD OF TX
TX
Enumeration date
04/28/2011
Last updated
07/11/2011
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