Autry, Alex Nelson

Autry, Alex Nelson is an individual health care provider with primary practice located at 1500 S Main St , Fort Worth TX 76104-4917. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Autry, Alex Nelson can be contacted via phone (817) 702-3431.

Contact Information

Primary practice address
1500 S Main St Fort Worth TX 76104-4917
Phone: (817) 702-3431
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 51401 Colorado
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X N9502 Texas
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 51401 Colorado

Profile Details

NPI number 1982845343
LBN Legal business name Autry, Alex Nelson
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2009
Last updated Aug 2nd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982845343 NPPES
Colorado MEDICAID 11329777
Colorado Other COA107696

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