RUTH R. WILEY, D.O., P.A.
Medical Practice at Terrell Ave, Fort Worth, TX

License number
Texas M6462
Category
Medical Practice
Type
Obstetrics & Gynecology
Owner
Name: DR. RUTH REPOSA WILEY D.O.
Title: D.O., P.A.
Phone: (817) 926-4118
Address
Address
851 W Terrell Ave, Fort Worth, TX 76104
National Provider ID: 1134374960
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RUTH R. WILEY, D.O., PA

1425 8 Ave, Fort Worth, TX 76104

Status:
Inactive
Industry:
Osteopathic Physician's Office
Doing business as:
Ruth R. Wiley, D.O., PA
Registration:
Jun 2, 2008
State ID:
0800986535
Business type:
Professional Association
President , Treasurer , Secretary , Executive Committee , Member:
Ruth R. Wiley President , Treasurer , Secretary , Executive Committee , Member, inactive
Agent:
John W Michener Jr,301 Commerce, Fort Worth, TX 76102 (Physical)
TIN:
32037207084

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