Individual
DOUGLAS E GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 884-3380
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 884-3380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F9499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352543801
—
TX
01
—
8J9053
BCBS
TX
Enumeration date
03/15/2006
Last updated
05/10/2016
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