Organization
FORT WORTH NEUROTECH, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRASE MAHAN (MANAGER)
(214) 675-0905
Entity
Organization
Contact information
Practice address
8409 PICKWICK LN # 175, DALLAS, TX 75225-5323
(214) 675-0905
(214) 317-4888
Mailing address
PO BOX 268996, OKLAHOMA CITY, OK 73126-8996
(214) 675-0905
(214) 317-4888
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
10/15/2008
Last updated
08/10/2009
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