Individual
KEVIN WELLS TIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-4007
(682) 885-1712
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
BP10059985
TX
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
S6072
TX
Other
Enumeration date
03/28/2017
Last updated
08/07/2024
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