National Provider Identifier Database

FORT WORTH NORTHSIDE COMMUNITY HEALTH CENTER
Voluntary or Charitable


Contact Information

FORT WORTH NORTHSIDE COMMUNITY HEALTH CENTER
2106 N. MAIN
FORT WORTH, TX76106-8570
Phone: 817-625-4254
Fax:
Website:
Specialty Taxonomy Code
* Voluntary or Charitable 251V00000X

* Indicates primary specialty

NPI Profile & details for FORT WORTH NORTHSIDE COMMUNITY HEALTH CENTER

NPI Number 1730182585
Legal business name
LBN
FORT WORTH NORTHSIDE COMMUNITY HEALTH CENTER
Authorized official EDDY HERRERA - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 05/24/2005
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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