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Contact Information

UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
855 MONTGOMERY ST
FORT WORTH, TX76107
 Phone: 817-735-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH · (Female)

NPI Number 1053416289
Status Active
Credentials
Entity Individual
Enumeration date 09/13/2006
Last updated 05/29/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX Medicaid 138980109
  • Other 00BA05 MEDICARE
  • TX Other CQ2055 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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