Provider Demographics
NPI:1477832483
Name:COUNTY OF TARRANT
Entity Type:Organization
Organization Name:COUNTY OF TARRANT
Other - Org Name:TARRANT COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLQUITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-321-5344
Mailing Address - Street 1:1101 S MAIN ST
Mailing Address - Street 2:SUITE 2106
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4802
Mailing Address - Country:US
Mailing Address - Phone:817-321-4700
Mailing Address - Fax:817-850-5845
Practice Address - Street 1:2596 E ARKANSAS LN STE 190
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1752
Practice Address - Country:US
Practice Address - Phone:817-321-4792
Practice Address - Fax:817-321-4790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0659873291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3669343-01Medicaid
TX542252Medicare PIN