Organization
HISHAM BISMAR, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HISHAM BISMAR MD (OWNER)
(817) 568-0004
Entity
Organization
Contact information
Practice address
11807 SOUTH FREEWAY, SUITE 362A, FORT WORTH, TX 76115-0337
(817) 568-0004
(817) 568-0804
Mailing address
11807 SOUTH FREEWAY, SUITE 362A, FORT WORTH, TX 76115-0337
(817) 568-0004
(817) 568-0804
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB100274
MEDICARE PTAN
TX
Enumeration date
12/19/2014
Last updated
12/19/2014
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