Tatum, Ross

Tatum, Ross is an sole proprietor health care provider with primary practice located at 3815 Lisbon St Ste 200 , Ft Worth TX 76107-5673. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Tatum, Ross can be contacted via phone (817) 989-1122.

Contact Information

Primary practice address
3815 Lisbon St Ste 200 Ft Worth TX 76107-5673
Phone: (817) 989-1122
Fax: (817) 989-2072
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X J0303 Texas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X J0303 Texas

Profile Details

NPI number 1366524993
LBN Legal business name Tatum, Ross
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2006
Last updated Feb 10th, 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 1366524993 NPPES
Texas MEDICAID P000T42H2

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