Alliance Heritage Trace Pllc

NPI #1689922627 in Fort Worth, Texas

Provider Information

NPI Number: 1689922627
Entity Type: Organization
Organization Name: Alliance Heritage Trace Pllc
Primary Specialty: Pediatrics
Enumeration Date: Aug 23, 2012
Last Updated: Oct 10, 2012

Practice Location

Address: 4400 HERITAGE TRACE PKWY
Address 2: SUITE 208
City: Fort Worth
State: Texas
ZIP Code: 76244-8901
Phone: (817) 741-5437

Authorized Official

Name: MR. BRUCE DAVID MARTIN, MD
Title: OWNER
Phone: (817) 741-5437

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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