IndividualActive
John Licciardone, D.O.
NPI 1407829641 · Neuromusculoskeletal Medicine & OMM Physician · Fort Worth, TX
Provider details
- NPI number
- 1407829641
- Entity type
- Individual
- Primary specialty
- Neuromusculoskeletal Medicine & OMM PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- H3103 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
Unthsc Patient Care Center
999 Montgomery
Fort Worth, TX 76107
Phone: (817) 735-2235
Fax: (817) 735-2480
Approximate (ZIP-level) locationGet directions
Mailing address
Unthsc Dept. of Quality Management
Fort Worth, TX 76107
Registry dates
- Enumerated
- 2006-02-08
- Last updated
- 2008-03-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.