Fort Worth Pediatrics, P.A.

LBN: Fort Worth Pediatrics, P.A.
Fort Worth Pediatrics, P.A. is an health care organization with primary practice located at 1108 S Henderson St , Fort Worth TX 76104-4430. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Fort Worth Pediatrics, P.A. can be contacted via phone (817) 335-3255, or through Richey, Diane via phone (817) 336-4040.

Contact Information

Primary practice address
1108 S Henderson St Fort Worth TX 76104-4430
Phone: (817) 335-3255
Fax: (817) 336-6780
Website:
Map and Directions
Authorized official contact:
Name: Richey, Diane
Phone: (817) 336-4040

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X Texas

Profile Details

NPI number 1972623031
LBN Legal business name Fort Worth Pediatrics, P.A.
DBA Doing business as
Authorized official Richey, Diane
Entity Organization
Organization subpart 1 No
Enumeration date Mar 30th, 2007
Last updated Jun 14th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972623031 NPPES
Texas Other 10001409 AMERIGROUP
Texas MEDICAID 130900702 AMERIGROUP
Texas Other 130900703 AMERIGROUP
Texas Other 00L72L AMERIGROUP

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