Provider Demographics
NPI:1033432844
Name:DANIEL S FORRER DO PA
Entity Type:Organization
Organization Name:DANIEL S FORRER DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FORRER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:940-584-0088
Mailing Address - Street 1:2650 FM 407 E
Mailing Address - Street 2:STE 155
Mailing Address - City:BARTONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226
Mailing Address - Country:US
Mailing Address - Phone:940-584-0088
Mailing Address - Fax:940-584-0098
Practice Address - Street 1:2650 FM 407 E
Practice Address - Street 2:STE 155
Practice Address - City:BARTONVILLE
Practice Address - State:TX
Practice Address - Zip Code:76226
Practice Address - Country:US
Practice Address - Phone:940-584-0088
Practice Address - Fax:940-584-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9513207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0087TEOtherBCBSTX
TXTXB143960Medicare PIN