Organization
C M PERSONS M D P A
Active
Organization
C M PERSONS M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M PERSONS CRNFA (NURSE)
(817) 399-1622
Entity
Organization
Contact information
Practice address
4625 BOAT CLUB RD, STE: 253, FORT WORTH, TX 76135-7022
(817) 399-1622
(817) 540-0759
Mailing address
4625 BOAT CLUB RD., STE: 253, FORT WORTH, TX 76135-7023
(817) 399-1622
(817) 540-0759
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F4368
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114261403
—
TX
Enumeration date
01/18/2011
Last updated
10/16/2013
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