| NAME |
FORT WORTH VA CLINIC |
| STATE |
TEXAS |
| STREET ADDR. 1 |
2201 SOUTHEAST LOOP 820 |
| CITY |
FORT WORTH |
| ZIP |
76119-5863 |
| OFFICIAL VA NAME |
FORT WORTH VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FORT WORTH VA CLINIC |
| ST. ADDR. 1 (MAILING) |
2201 SOUTHEAST LOOP 820 |
| CITY (MAILING) |
FORT WORTH |
| STATE (MAILING) |
TEXAS |
| ZIP (MAILING) |
76119-5863 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1285687319
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
549BY |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1285687319
-
- CODING SYSTEM: VASTANUM
- ID: 549BY
-
- CODING SYSTEM: CLIA
- ID: 45D0987930
|
