Takata, Theodore Sunao

Takata, Theodore Sunao is an individual health care provider with primary practice located at 1300 W Terrell Ave #500, Fort Worth TX 76104-2800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, which is considered as his primary health care specialty. Takata, Theodore Sunao can be contacted via phone (817) 252-5000.

Contact Information

Primary practice address
1300 W Terrell Ave #500 Fort Worth TX 76104-2800
Fax: (817) 252-5060
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X K8508 Texas

Profile Details

NPI number 1801884382
LBN Legal business name Takata, Theodore Sunao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Aug 15th, 2011 - about 13 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 1801884382 NPPES
Texas MEDICAID 039267205
Texas MEDICAID 039267203
Texas Other P00226814
Texas Other 8M6142

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