University Family Medical Clinic P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

H0939 Issued in TX

Legal business name

UNIVERSITY FAMILY MEDICAL CLINIC P.A.

Practice address

117 University Dr
Fort Worth, TX 76107-1922

Phone

(817) 338-0555

Fax

(817) 338-4039

NPI assigned

Aug 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. H Thomas Willard, D.O.

Title

Owner

Phone

(817) 338-0555

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1407049034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 UNIVERSITY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761071922",
            "telephone_number": "817-338-0555",
            "fax_number": "817-338-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 UNIVERSITY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761071922",
            "telephone_number": "817-338-0555",
            "fax_number": "817-338-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY FAMILY MEDICAL CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-338-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "H0939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Seating and Mobility LLC
• United Wound & Vascular Institute Texas PLLC
• Universal Clinical Care LLC.
• Universal Health Rehab Services, Inc
• Universal Staffing, Inc.
• University of North Texas
• University of North Texas Health Science Center at Fort Worth
• University of North Texas Health Science Center at Fort Worth
• University of North Texas Health Science Center at Fort Worth
• University of North Texas Health Science Center at Fort Worth

• Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.