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FORTH WORTH SURGICAL ASSOCIATES PA
NPI 1679561641
Surgery in Fort Worth, TX

Active since October 12, 2005
6100 HARRIS PKWY, #390, FORT WORTH, TX 76132(817) 370-9011(817) 346-0380 Get Directions Write a Review

NPPES record last updated: November 28, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Forth Worth Surgical Associates Pa NPPES

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

FORTH WORTH SURGICAL ASSOCIATES PA (NPI 1679561641) is a healthcare organization registered as a surgery in Fort Worth, Texas and active in the NPI registry since October 2005. The organization lists William Robert Pettey, Owner, as its authorized official.

NPPES Registry Identity

NPI1679561641
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameFORTH WORTH SURGICAL ASSOCIATES PA
Location Address6100 HARRIS PKWY, #390Fort Worth, TX 76132-4128
Mailing Address6100 Harris Pkwy, #390Fort Worth, TX 76132-4128 · (817) 370-9011 · Fax (817) 346-0380
Phone(817) 370-9011
Fax(817) 346-0380
Organization SubpartNo
Authorized OfficialWilliam Robert PetteyOwner · (817) 370-9011
Enumeration DateOctober 12, 2005
Last NPPES UpdateNovember 28, 2007
✔ NPI 1679561641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in TX · G8340
Definition
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.
6100 HARRIS PKWY, Fort Worth, TX 76132
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Other Identifiers 4

Other91159Amerigroup
Medicare UPINC20472
Other4254295Aetna
Medicare PIN00L60V

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.

MRS. ANJANETTE OSTROM AGACNP-BC
Nurse Practitioner (Acute Care)
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 433-5977
RAJKUMAR SOMASUNDARAM FNP-BC
Nurse Practitioner (Family)
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (490) 681-7820
HANSON INTERNAL MEDICINE, P.A.
Internal Medicine
6100 HARRIS PKWY, SUITE 240
FORT WORTH, TX 76132
Tarrant County (817) 504-5699
PAMELA J MAINOUS
Specialist/Technologist, Other (Surgical Assistant)
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 346-5000
DEVEN EMMANUEL GULICK MD
Internal Medicine
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 433-5977
GREGORY WAYNE HANSON M.D.
Internal Medicine
6100 HARRIS PKWY, SUITE 240
FORT WORTH, TX 76132
Tarrant County (817) 504-5699
LYNNE R TILKIN DO
Family Medicine
6100 HARRIS PKWY, STE 350
FORT WORTH, TX 76132
Tarrant County (817) 433-5580
DR. ILONA NEKHAYEVA MD., PHD
Family Medicine
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 433-5977

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 Forth Worth Surgical Associates PA's NPI number?

The NPI number for Forth Worth Surgical Associates PA is 1679561641. It was assigned to this organization in the NPPES registry on October 12, 2005.

Where is Forth Worth Surgical Associates PA located?

Forth Worth Surgical Associates PA is located at 6100 Harris Pkwy #390, Fort Worth, TX 76132. The listed phone number is (817) 370-9011.

What is Forth Worth Surgical Associates PA's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for Forth Worth Surgical Associates PA was last updated on November 28, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.