Willard, John Edward

Willard, John Edward is an individual health care provider with primary practice located at 1300 W Terrell Ave Ste 500 , Fort Worth TX 76104-2810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Willard, John Edward can be contacted via phone (817) 252-5000.

Contact Information

Primary practice address
1300 W Terrell Ave Ste 500 Fort Worth TX 76104-2810
Fax: (817) 252-5060
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X H0940 Texas

Profile Details

NPI number 1083602452
LBN Legal business name Willard, John Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Sep 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083602452 NPPES
Texas Other 110182266 RAIL ROAD MEDICARE
Texas Other 85K271 RAIL ROAD MEDICARE
Texas MEDICAID 1378788-01 RAIL ROAD MEDICARE
Texas MEDICAID 137878812 RAIL ROAD MEDICARE

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