| NPI | 1336353366 |
|---|---|
| Doing Business As | FORT WORTH ENT, PA |
| Entity Type | Organization |
| Authorized Contact | VICKY L. VANVLECK Practice Manager 817-335-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H2007) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L4150) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2011-01-24 |