Individual
MR. DARRELL WAYNE WORTHEM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
801 W SEVENTH ST, FT WORTH, TX 76102-3510
(682) 885-4105
Mailing address
3500 DANIEL DR, ARLINGTON, TX 76014-3335
(817) 901-0943
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00816
TX
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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