UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH (NPI# 1003133083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003133083 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH |
| Practice Address |
855 Montgomery St Fort Worth TX 76107 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8177352000 |
| Mailing Telephone | 8177352000 |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2018-06-12 |
| Authorized Official Name | LESLIE MCGEE HENDERSON (REVENUE CYCLE DIRECTOR) |
| Authorized Official Telephone | 8177352008 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 0056TW | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2737 Sherman St, Grand Prairie, TX 750511027 | 8177352000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659473056 | University of North Texas Health Science Center At Fort Worth | Advanced Practice Midwife | 1307 8th Ave Ste 403, Fort Worth, TX 76104-4143 | 2006-09-05 |
| 1992355499 | University of North Texas Health Science Center At Fort Worth | Neuromusculoskeletal Medicine & OMM | 1800 W Chestnut St, Denton, TX 76201 | 2019-09-17 |
| 1538383328 | University of North Texas Health Science Center At Fort Worth | Physician Assistant | 855 Montgomery St, Fort Worth, TX 76107 | 2007-04-12 |
| 1659595445 | University of North Texas Health Science Center At Fort Worth | Physician Assistant | 855 Montgomery St, Fort Worth, TX 76107 | 2007-04-12 |
| 1316060882 | University of North Texas Health Science Center At Fort Worth | Physician Assistant | 1305 E Seminary Dr, Fort Worth, TX 76115 | 2007-04-09 |
| 1891818381 | University of North Texas Health Science Center At Fort Worth | Physician Assistant | 855 Montgomery St, Fort Worth, TX 76107 | 2007-04-09 |
| 1578686127 | University of North Texas Health Science Center At Fort Worth | Physician Assistant | 3500 Camp Bowie Blvd, Fort Worth, TX 76107 | 2007-04-09 |
| 1144328634 | University of North Texas Health Science Center At Fort Worth | Psychologist | 855 Montgomery St, Fort Worth, TX 76107 | 2006-09-20 |
| 1417054024 | University of North Texas Health Science Center At Fort Worth | Allergy & Immunology | 855 Montgomery St, Fort Worth, TX 76107 | 2006-09-19 |
| 1053416289 | University of North Texas Health Science Center At Fort Worth | Physician Assistant | 855 Montgomery St, Fort Worth, TX 76107 | 2006-09-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH | 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2553 |
| Street Address |
855 MONTGOMERY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1952870354 | Nancy Carolina Nicoloso | Family Medicine | 6302 Lake Worth Blvd Ste A3963, Fort Worth, TX 76135-3607 | 2018-11-15 |
| 1245717586 | Julia Dubose | Family Medicine | 4100 Heritage Trace Pkwy Ste 116, Fort Worth, TX 76244 | 2018-07-19 |
| 1609307115 | Yara Hamade Gonzales | Family Medicine | 4701 Bryant Irvin Rd, Fort Worth, TX 76132-3603 | 2017-03-26 |
| 1558732321 | Andres Morgado Perez | Family Medicine | 1325 Pennsylvania Ave Ste 750, Fort Worth, TX 76104-2168 | 2015-10-19 |
| 1114304805 | Davis Wellness Ltd LLP | Family Medicine | 3750 S. University Dr., Suite 201, Fort Worth, TX 76109-3701 | 2015-05-01 |
| 1902298417 | Jack Lynwood Judson, Md | Family Medicine | 1800 Malibar Rd, Fort Worth, TX 76116-1834 | 2015-02-21 |
| 1104243468 | Henry Dollahite | Family Medicine | 6205 Locke Ave, Fort Worth, TX 76116-4636 | 2014-03-25 |
| 1447676689 | Janet Shackelford | Family Medicine | 5001 Golden Triangle Blvd, # 1024, Fort Worth, TX 76244 | 2014-03-12 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.