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Individual

DR. JANICE KELLY TOMBERLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1612 HOSPITAL PKWY, BEDFORD, TX 76022-6913
(817) 685-4700
(817) 685-4595
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
H2839
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136929001
TX
05
136929005
TX
01
136929010
CSHCN
TX
05
136929012
TX
01
8R1570
BLUE CROSS OF TEXAS
TX
Enumeration date
06/04/2006
Last updated
06/20/2008
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