John Edward Willard
Interventional Cardiology
1300 W Terrell Ave Ste 500
Fort Worth
, Texas 76104-2810
John Edward Willard
Interventional Cardiology
1300 W Terrell Ave Ste 500
Fort Worth
, Texas 76104-2810
(817) 252-5060
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About
Features
Specialties
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- John Edward Willard
- 1300 W Terrell Ave Ste 500
- Fort Worth, TX
- Zip : 76104-2810
- Fax : (817) 252-5060
- Phone : (817) 252-5000
Second Address
- John Edward Willard
- 1300 W Terrell Ave Ste 500
- Fort Worth, TX
- Zip : 76104-2810
- Fax : (817) 252-5060
- Phone : (817) 252-5000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0011X | Interventional Cardiology | H0940 | TX |
National Provider Identifier
| NPI | 1083602452 |
|---|---|
| Provider Name | John Edward Willard |
| First Address | Fort Worth, TX 76104-2810 |
| Second Address | Fort Worth, TX 76104-2810 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2005 |
| Last Update Date | 15/09/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110182266 | RAIL ROAD MEDICARE (01) | TX |
| 1378788-01 | (05) | TX |
| 137878812 | (05) | TX |
| 85K271 | BLUE CROSS (01) | TX |
| C23499 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.