Provider Demographics
NPI:1063464691
Name:JOHN MIERS DO
Entity Type:Organization
Organization Name:JOHN MIERS DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-926-1333
Mailing Address - Street 1:1650 W MAGNOLIA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4009
Mailing Address - Country:US
Mailing Address - Phone:817-926-1333
Mailing Address - Fax:817-927-2528
Practice Address - Street 1:1650 W MAGNOLIA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4009
Practice Address - Country:US
Practice Address - Phone:817-926-1333
Practice Address - Fax:817-927-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty