Organization
BLACK HEART ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA ROBINSON (CLINIC DIRECTOR)
(817) 683-8859
Entity
Organization
Contact information
Practice address
5151 GREENLEE ST, FORT WORTH, TX 76112-4881
(817) 683-8859
Mailing address
1029 KAYLIE ST, GRAND PRAIRIE, TX 75052-7152
(817) 683-8859
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
10/12/2021
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