TIMOTHY L BLACK MD
NPI 1669453940
Surgery - Pediatric Surgery in Fort Worth, TX

Active since November 14, 2005
1500 COOPER ST, FORT WORTH, TX 76104(682) 885-7080(682) 885-7085 Get Directions Write a Review

NPPES record last updated: November 5, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Timothy L Black Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY L BLACK MD (NPI 1669453940) is an individual pediatric surgery provider in Fort Worth, Texas, licensed in Texas (H1467) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1669453940
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameTIMOTHY L BLACKCredential: MD
Location Address1500 COOPER STFort Worth, TX 76104-2710
Mailing AddressPo Box 99371Fort Worth, TX 76199-0371 · (682) 885-4157 · Fax (682) 885-1903
Fax(682) 885-7085
Sole ProprietorNo
Enumeration DateNovember 14, 2005
Last NPPES UpdateNovember 5, 2012
NPI 1669453940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License Licensed in TX · H1467
Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

1500 COOPER ST, Fort Worth, TX 76104

Other Identifiers 7

Other1750369203Npi Group Number
Other8G3393TX · Bcbstx Pin
Medicaid117647108TX
Medicare PIN00U87ZTX
Medicare PIN8G7178TX
Medicaid117647106TX
Medicare UPINE79519

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics (Neurodevelopmental Disabilities)
1500 COOPER ST
FORT WORTH, TX 76104
Social Worker (Clinical)
1500 COOPER ST
FORT WORTH, TX 76104
Pediatrics (Pediatric Cardiology)
1500 COOPER ST
FORT WORTH, TX 76104
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1500 COOPER ST
FORT WORTH, TX 76104
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Black's NPI number?

The NPI number for Timothy Black is 1669453940. It was assigned to this individual provider in the NPPES registry on November 14, 2005.

Where is Timothy Black located?

Timothy Black practices at 1500 Cooper St, Fort Worth, TX 76104. The listed phone number is (682) 885-7080.

What is Timothy Black's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

When was this NPI record last updated?

The NPPES record for Timothy Black was last updated on November 5, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.