Fort Worth Ent, Pa
LBN: Fort Worth Ent,P.A.
Fort Worth Ent, Pa is an health care organization with primary practice located at 1250 8Th Ave Suite 135, Fort Worth TX 76104. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty.
Fort Worth Ent,P.A. can be contacted via phone (817) 335-8151, or through Vanvleck, Vicky L. via phone (817) 335-8151.
Contact Information
Primary practice address
1250 8Th Ave Suite 135
Fort Worth TX 76104
Phone: (817) 335-8151
Fax: (817) 335-2670
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | H2007 | Texas |
| Other Service Providers / Specialist | 174400000X | L4150 | Texas |
Profile Details
| NPI number | 1336353366 |
|---|---|
| LBN Legal business name | Fort Worth Ent,P.A. |
| DBA Doing business as | Fort Worth Ent, Pa |
| Authorized official | Vanvleck, Vicky L. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 9th, 2007 |
| Last updated | Jan 24th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336353366 | NPPES |
| Texas | Other | 8G2131 | TODD E. SAMUELSON MD BCBS |
| Texas | MEDICAID | 031074002 | TODD E. SAMUELSON MD BCBS |
| Texas | MEDICAID | 166927701 | TODD E. SAMUELSON MD BCBS |
| Texas | Other | H2007 | TODD E. SAMUELSON MD BCBS |
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