Provider Demographics
NPI:1568656502
Name:USMD HOSPITAL AT FORT WORTH, L.P.
Entity Type:Organization
Organization Name:USMD HOSPITAL AT FORT WORTH, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD OF DIRECTORS
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIDUCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-493-4000
Mailing Address - Street 1:6333 N STATE HIGHWAY 161
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2215
Mailing Address - Country:US
Mailing Address - Phone:214-493-4000
Mailing Address - Fax:
Practice Address - Street 1:5900 DIRKS RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-5473
Practice Address - Country:US
Practice Address - Phone:817-433-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital