Organization
TEXAS HEALTH CARE, PLLC
Active
Other names
Privia Medical Group North Texas
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D TATUM MD (CEO)
(817) 740-8400
Entity
Organization
Contact information
Practice address
110 MARY LOU DR. STE. 100, WILLOW PARK, TX 76087-8767
(817) 930-2030
(817) 930-2031
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-0205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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