Tatum, Ross
Tatum, Ross is an sole proprietor health care provider with primary practice located at 3815 Lisbon St Ste 200 , Ft Worth TX 76107-5673. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Tatum, Ross can be contacted via phone (817) 989-1122.Contact Information
Primary practice address
3815 Lisbon St Ste 200
Ft Worth TX 76107-5673
Phone: (817) 989-1122
Fax: (817) 989-2072
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | J0303 | Texas |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | J0303 | Texas |
Profile Details
NPI number | 1366524993 |
---|---|
LBN Legal business name | Tatum, Ross |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 20th, 2006 |
Last updated | Feb 10th, 2014 - about 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1366524993 | NPPES |
Texas | MEDICAID | P000T42H2 |
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