Provider Demographics
NPI:1912125436
Name:BATTLES, VICTOR E (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:E
Last Name:BATTLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10193 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-9503
Mailing Address - Country:US
Mailing Address - Phone:817-249-2710
Mailing Address - Fax:817-249-7920
Practice Address - Street 1:4200 SOUTH FWY
Practice Address - Street 2:SUITE 418
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1400
Practice Address - Country:US
Practice Address - Phone:817-366-4129
Practice Address - Fax:817-249-7920
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00BV083Medicaid
TXP00BV083Medicaid
TXB21122Medicare UPIN