TIMOTHY L BLACK

FORT WORTH, TX
NPI1669453940
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2086S0120X Surgery, Pediatric Surgery
(Licence: TX  H1467)
Enumeration Date2005-11-14
Last Update Date2012-11-05
Business Address
-- TIMOTHY L BLACK MD
1500 COOPER ST
FORT WORTH, TX 76104-2710
Phone number: 682-885-7080
Mailing Address
-- TIMOTHY L BLACK MD
PO BOX 99371
FORT WORTH, TX 76199-0371
Phone number: 682-885-4157
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