Individual
BRIAN ISABOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6100 WESTERN PL, FORT WORTH, TX 76107-4600
(817) 564-0107
Mailing address
2617 PROSPECT AVE, FORT WORTH, TX 76164-7048
(254) 218-0614
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
322759
TX
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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