Organization
TEXAS HEALTH CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D TATUM MD (CEO)
(817) 740-8400
Entity
Organization
Contact information
Practice address
7100 OAKMONT BLVD STE 205, FORT WORTH, TX 76132-3908
(817) 558-4600
(817) 558-4602
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8450
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155109506
—
TX
Enumeration date
03/01/2021
Last updated
03/01/2021
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