Organization
RS5 MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY M KJELDGAARD DO (OWNER / PRESIDENT)
(817) 283-5252
Entity
Organization
Contact information
Practice address
4444 HERITAGE TRACE PKWY, STE 408, FORT WORTH, TX 76244
(817) 283-5252
Mailing address
4444 HERITAGE TRACE PKWY, STE 408, FORT WORTH, TX 76244
(817) 283-5252
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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