Provider Demographics
NPI:1508807363
Name:B J WROTEN, M.D., P.A.
Entity Type:Organization
Organization Name:B J WROTEN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:WROTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-877-3177
Mailing Address - Street 1:801 W TERRELL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3100
Mailing Address - Country:US
Mailing Address - Phone:817-877-3177
Mailing Address - Fax:817-877-3176
Practice Address - Street 1:801 W TERRELL AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3100
Practice Address - Country:US
Practice Address - Phone:817-877-3177
Practice Address - Fax:817-877-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00T773Medicare ID - Type Unspecified
TXB27682Medicare UPIN