Takata, Theodore Sunao
Takata, Theodore Sunao is an individual health care provider with primary practice located at 1300 W Terrell Ave #500, Fort Worth TX 76104-2800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, which is considered as his primary health care specialty. Takata, Theodore Sunao can be contacted via phone (817) 252-5000.Contact Information
Primary practice address
1300 W Terrell Ave #500
Fort Worth TX 76104-2800
Phone: (817) 252-5000
Fax: (817) 252-5060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | K8508 | Texas |
Profile Details
| NPI number | 1801884382 |
|---|---|
| LBN Legal business name | Takata, Theodore Sunao |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Aug 15th, 2011 - about 15 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 | 1801884382 | NPPES |
| Texas | MEDICAID | 039267205 | |
| Texas | MEDICAID | 039267203 | |
| Texas | Other | P00226814 | |
| Texas | Other | 8M6142 |
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