Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 31346 | AL |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | N6297 | TX |
NPI | 1194992263 |
---|---|
Provider Name | Joseph Leon Fitzwater |
First Address | Fort Worth, TX 76104-2133 |
Second Address | Fort Worth, TX 76104-2133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 16/07/2015 |