West Fort Worth Dermatology, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

H7639 Issued in TX

Legal business name

WEST FORT WORTH DERMATOLOGY, P.A.

Practice address

4840 Bryant Irvin CT
Suite 104
Fort Worth, TX 76107-7679

Phone

(817) 989-0300

Fax

(817) 377-0970

NPI assigned

Nov 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Laura Furniss Morris, M.D.NPI 1588612501

Title

Owner/Physician

Phone

(817) 713-4301

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Morris, M.D.

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1588612501
  Medicare reassignment NPD Authorized official
• Clyde Leroy Goodman, MD

  • General Practice Physician
  • Fort Worth, TX
  • NPI 1801823083
  NPD (past)

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506384000000",
    "number": "1447702964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 BRYANT IRVIN CT",
            "address_2": "SUITE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077679",
            "telephone_number": "817-989-0300",
            "fax_number": "817-377-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 BRYANT IRVIN CT",
            "address_2": "SUITE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077679",
            "telephone_number": "817-989-0300",
            "fax_number": "817-377-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FORT WORTH DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2017-09-26",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "FURNISS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "817-713-4301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "H7639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany R Wertz, LCSW
• Barnedra Rachel Wesley
• Megan Wesling, PHARM.D.
• Krystyna Wesp, D.O.
• Mary Carolyn Wesson, CRNA
• West Keller Dental
• West LPN Fort Worth Oncology PLLC
• West Magnolia Plastic Surgery PA
• West Magnolia Surgery Center
• West Side Orthopaedic Clinic

• Dermatology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.