Hendricks, George David

Hendricks, George David is an individual health care provider with primary practice located at 1201 Summit Ave , Fort Worth TX 76102-4427. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Hendricks, George David can be contacted via phone (817) 332-2020.

Contact Information

Primary practice address
1201 Summit Ave Fort Worth TX 76102-4427
Phone: (817) 332-2020
Fax: (817) 332-4797
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X F6734 Texas

Profile Details

NPI number 1063418036
LBN Legal business name Hendricks, George David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated May 13th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063418036 NPPES
Texas Other 88Z910 BCBS
Texas MEDICAID 135564601 BCBS
Texas MEDICAID 135564603 BCBS

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