Individual
DR. JEREMY PAUL WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5751 EDWARDS RANCH ROAD, SUITE 200, FORT WORTH, TX 76109
(817) 332-8848
(817) 335-2670
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8450
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M8419
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
760330807
TAX ID
TX
01
—
8G2133
BCBS
TX
01
—
M8419
LICENSE
TX
Enumeration date
04/17/2007
Last updated
04/16/2018
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