Individual
DR. ALICIA HENRY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 8TH AVE, SUITE 320, FORT WORTH, TX 76104-4139
(817) 924-2111
(817) 546-3980
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 924-2111
(817) 546-3980
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
N9087
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283396401
—
TX
01
—
P00991902
RAILROAD MEDICARE
TX
Enumeration date
05/27/2008
Last updated
02/03/2012
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