Organization
ALLIANCE HERITAGE TRACE PLLC
Active
Other names
Alliance Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE DAVID MARTIN MD (OWNER)
(817) 741-5437
Entity
Organization
Contact information
Practice address
4400 HERITAGE TRACE PKWY, SUITE 208, FORT WORTH, TX 76244-8901
(817) 741-5437
(888) 400-5412
Mailing address
12461 TIMBERLAND BLVD, SUITE 309, FORT WORTH, TX 76244-5213
(817) 741-5437
(888) 400-5412
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L8824
TX
Other
Enumeration date
08/23/2012
Last updated
10/10/2012
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