Tatum, Larry D

Tatum, Larry D is an individual health care provider with primary practice located at 1250 8Th Ave Ste 430 , Fort Worth TX 76104-4144. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Tatum, Larry D can be contacted via phone (817) 923-5558.

Contact Information

Primary practice address
1250 8Th Ave Ste 430 Fort Worth TX 76104-4144
Phone: (817) 923-5558
Fax: (817) 923-0087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X F4585 Texas

Profile Details

NPI number 1437195609
LBN Legal business name Tatum, Larry D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Feb 28th, 2020 - about 6 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 1437195609 NPPES
Texas MEDICAID 047134403
Texas MEDICAID 047134405
Texas Other 160059746

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