Organization
FOREST PARK MEDICAL CENTER AT SOUTHLAKE, LLC
Active
Other names
FPMC Southlake
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES NASAM (CEO)
(469) 330-6740
Entity
Organization
Contact information
Practice address
421 EAST STATE HIGHWAY 114, SOUTHLAKE, TX 76092
(817) 865-4400
(817) 865-4840
Mailing address
421 EAST STATE HIGHWAY 114, SOUTHLAKE, TX 76092
(817) 865-4400
(817) 865-4840
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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