Provider Demographics
NPI:1225187727
Name:TARRANT WOMENS HEALTH MEDICAL GROUP, P.A.
Entity Type:Organization
Organization Name:TARRANT WOMENS HEALTH MEDICAL GROUP, P.A.
Other - Org Name:WOMEN'S HEALTH MEDICAL GROUP, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-346-5336
Mailing Address - Street 1:6100 HARRIS PKWY
Mailing Address - Street 2:#140
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4131
Mailing Address - Country:US
Mailing Address - Phone:817-346-5336
Mailing Address - Fax:817-346-5366
Practice Address - Street 1:6100 HARRIS PKWY
Practice Address - Street 2:#140
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4131
Practice Address - Country:US
Practice Address - Phone:817-346-5336
Practice Address - Fax:817-346-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCG1422OtherMEDICARE RAILROAD
TX081266101Medicaid
TX0064DJOtherBLUE CROSS BLUE SHIELD
TXCG1422OtherMEDICARE RAILROAD
TX081266101Medicaid