Individual
MONTY V TRIMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3455 LOCKE AVE, SUITE 210, FORT WORTH, TX 76107-5719
(817) 529-6200
(817) 529-6205
Mailing address
3455 LOCKE AVE, SUITE 210, FORT WORTH, TX 76107-5719
(817) 529-6200
(817) 529-6205
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L4150
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166931901
—
TX
01
—
7679401
AETNA
TX
01
—
8G2130
BCBS OF TEXAS
TX
Enumeration date
09/20/2006
Last updated
04/03/2015
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