NPI 1003062472

Self Richard Dba

Organisation Private Vehicle Fort Worth, TX

Practice location

Address: 6701 Calmont Ave APT 101, Fort Worth, TX 76116-4239
Phone: (817) 304-2892
Fax: (817) 246-4764

Authorised official

Name: Richard Ray Baker
Title: Home Health Nurse Aide
Phone: (817) 304-8292

Registered specialties (2)

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence 09332825 (TX)

Other Private Vehicle providers in Texas →

Physical Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320700000X Licence 09332825 (TX)

Other Residential Treatment Facility, Physical Disabilities providers in Texas →

Registry record

NPI: 1003062472
Entity type: Organization
NPI issued: 17 Aug 2008
Record last updated: 17 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.