FORTH WORTH SURGICAL ASSOCIATES PA (NPI# 1679561641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679561641 |
| Entity Type | Organization |
| Organization Name | FORTH WORTH SURGICAL ASSOCIATES PA |
| Practice Address |
6100 Harris Pkwy #390 Fort Worth TX 76132-4128 |
| Practice Telephone | 8173709011 |
| Practice Fax Number | 8173460380 |
| Mailing Telephone | 8173709011 |
| Mailing Fax Number | 8173460380 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2007-11-28 |
| Authorized Official Name | WILLIAM ROBERT PETTEY (OWNER) |
| Authorized Official Telephone | 8173709011 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | G8340 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 4254295 | 01 | |
| AMERIGROUP | 91159 | 01 |
| Street Address |
6100 HARRIS PKWY #390 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76132-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851392401 | Fredric Dorhauer Johnson | Family Medicine | 6100 Harris Pkwy, Suite 205, Fort Worth, TX 76132-4124 | 2005-08-04 |
| 1417583030 | Isabelle Nyota | Registered Nurse | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2020-03-15 |
| 1134632029 | Erin Lynn Morehead | Nurse Practitioner | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2017-11-14 |
| 1013431642 | Pamela J Mainous | Specialist/Technologist, Other | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2017-07-25 |
| 1265881767 | Lisa Phillips | Physician Assistant | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2016-06-07 |
| 1174980536 | Elizabeth Baker | Physician Assistant | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2016-01-15 |
| 1033506480 | Jose Calderon | Physician Assistant | 6100 Harris Pkwy, Suite 345, Fort Worth, TX 76132-4101 | 2015-04-23 |
| 1447646559 | Azfar Syed | Family Medicine | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2015-04-15 |
| 1174919641 | Grant Warren Potter | Family Medicine | 6100 Harris Pkwy, Fort Worth, TX 76132 | 2015-04-12 |
| 1306241583 | Jennifer Lynn Chavez | Nurse Practitioner | 6100 Harris Pkwy, Suite # 285, Fort Worth, TX 76132-4101 | 2014-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669843 | Rubilene Spinks | Pharmacist | 6300 Oakmount Blvd, Fort Worth, TX 76132 | 2020-11-03 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1568029320 | Ty Desilets | Physical Therapist | 5959 Bryant Irvin Rd Suite 100, Fort Worth, TX 76132 | 2019-05-28 |
| 1750844049 | Fort Worth Surgical Center Lp | Clinic/Center | 6949 Bryant Irvin Road, Fort Worth, TX 76132 | 2019-04-12 |
| 1063971232 | Symetria Health of Texas, LLC | Clinic/Center | 7299 Hawkins View Drive, Fort Worth, TX 76132 | 2019-03-18 |
| 1275015612 | Falguni Udayan Patel | Nurse Practitioner | 6100 Harris Pkwy Ste 1230, Fort Worth, TX 76132 | 2018-09-02 |
| 1881110161 | Because De Cares | Private Vehicle | 7101 Bryant Irving Road #33104, Fort Worth, TX 76132 | 2017-08-17 |
| 1871045708 | Cns - F.w., LLC | Clinic/Center | 6940 Harris Parkway, Fort Worth, TX 76132 | 2016-10-26 |
| 1790233294 | Prime Diagnostic Imaging of Fort Worth, LLC | Clinic/Center | 6491 Southwest Blvd., Benbrook, TX 76132 | 2016-09-14 |
| Find all providers in zip 76132 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093273781 | Southwest Vascular P.C. | Surgery | 4375 Booth Callaway Suite 501, Fort Worth, TX 76180 | 2019-03-12 |
| 1689102022 | Kanayochukwu J. Anya Md Facs, Pllc | Surgery | 6100 Harris Pkwy Ste 380, Fort Worth, TX 76132-4128 | 2017-05-30 |
| 1093114530 | Patel Surgical Pllc | Surgery | 909 9th Ave Ste 208, Fort Worth, TX 76104-3931 | 2014-08-21 |
| 1689918948 | Texas Health Care, P.l.l.c. | Surgery | 6100 Harris Pkwy Ste 270, Fort Worth, TX 76132-4132 | 2012-11-26 |
| 1639447832 | Henry V Birdwell Jr. | Surgery | 4204 Lakewood Dr, Fort Worth, TX 76135-2704 | 2011-12-02 |
| 1669628780 | Fort Worth Clinic Specialty Care, Pllc | Surgery | 212 Cattlebaron Park Dr, Fort Worth, TX 76108-9512 | 2008-08-08 |
| 1265694731 | Balaguru Kolandavelo Sambandam | Surgery | 3025 N Tarrant Pkwy Ste 100, Fort Worth, TX 76177-8625 | 2008-06-26 |
| 1427252378 | Arsalla Islam | Surgery | 4312 Heritage Trace Pkwy, Ste 704, Fort Worth, TX 76244-9132 | 2007-06-13 |
| 1750590485 | John Landis Birbari Jr. | Surgery | 1325 Pennsylvania Avenue, Suite 720, Fort Worth, TX 76104-2144 | 2007-05-21 |
| 1427267145 | Paul Edward Gray Jr. | Surgery | 1325 Pennsylvania Ave., Suite 720, Fort Worth, TX 76104-2144 | 2007-05-21 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.