Provider Demographics
NPI:1316274806
Name:E.SCOTT FERREE, D.O., P.A.
Entity type:Organization
Organization Name:E.SCOTT FERREE, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FERREE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-371-2766
Mailing Address - Street 1:4021 ROTHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7919
Mailing Address - Country:US
Mailing Address - Phone:817-371-2766
Mailing Address - Fax:
Practice Address - Street 1:4021 ROTHINGTON RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7919
Practice Address - Country:US
Practice Address - Phone:817-371-2766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0009TBOtherBCBS
TX210570201Medicaid
TX210570201Medicaid