Provider Demographics
NPI:1558639633
Name:ORTHOPEDIC CENTER OF ARLINGTON, PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC CENTER OF ARLINGTON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WHITTENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-468-8400
Mailing Address - Street 1:400 W ARBROOK BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3174
Mailing Address - Country:US
Mailing Address - Phone:817-468-8400
Mailing Address - Fax:817-468-8512
Practice Address - Street 1:400 W ARBROOK BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3174
Practice Address - Country:US
Practice Address - Phone:817-468-8400
Practice Address - Fax:817-468-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1779207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty