| Michael E Truman DO PA | |
|
2401 Canton Dr Fort Worth TX 76112-5001 | |
| (817) 446-5500 | |
| (817) 446-5509 |
| Full Name | Michael E Truman DO PA |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2401 Canton Dr, Fort Worth, Texas |
| Authorized Official Name and Position | Michael E Truman (OWNER) |
| Authorized Official Contact | 8174465500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E Truman DO PA 2401 Canton Dr Fort Worth TX 76112-5001 Ph: (817) 446-5500 | Michael E Truman DO PA 2401 Canton Dr Fort Worth TX 76112-5001 Ph: (817) 446-5500 |
| NPI Number | 1275715518 |
|---|---|
| Provider Enumeration Date | 11/28/2007 |
| Last Update Date | 05/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275715518 | NPI | - | NPPES |
| 122334903 | Medicaid | TX | |
| 0092RA | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | D8836 (Texas) | Primary |
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