Texas Health Care, P.L.L.C.
Organization Active NPI Obstetrics & Gynecology Physician · Keller, TX
NPI 1043554397 · NPPES record last updated Nov 26, 2012
Key facts
- NPI
- 1043554397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- TEXAS HEALTH CARE, P.L.L.C.
- Practice address
- 1141 Keller Pkwy Ste a
Keller, TX 76248-1628 - Phone
- (817) 741-2601
- Fax
- (817) 745-2601
- NPI assigned
- Nov 26, 2012
- Organization subpart
- No
Authorized official
- Name
- Larry D. Tatum, MD
- Title
- Ceo
- Phone
- (817) 740-8400
Corporate family (same tax ID) 23
National Provider Directory
- Tax ID family
- Texas Health Care PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
1141 Keller Pkwy Ste a
Keller, TX 76248-1628
Mailing address
P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155109501 | Medicaid | TX |
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All providers in Keller, TX · Obstetrics & Gynecology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.