Podgore, John K
Podgore, John K is an individual health care provider with primary practice located at 855 Montgomery St , Fort Worth TX 76107-2553. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Podgore, John K can be contacted via phone (817) 735-2363.Contact Information
Primary practice address
855 Montgomery St
Fort Worth TX 76107-2553
Phone: (817) 735-2363
Fax: (817) 735-2653
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | D9864 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases | 2080P0208X | D9864 | Texas |
Profile Details
| NPI number | 1407810344 |
|---|---|
| LBN Legal business name | Podgore, John K |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2006 |
| Last updated | Feb 16th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407810344 | NPPES |
| Texas | Other | 125514303 | CSHCN |
| Texas | MEDICAID | 125514302 | CSHCN |
| Texas | Other | 847309 | CSHCN |
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