IndividualActive
Richard Butorac, IDC
NPI 1669427290 · Independent Duty Corpsman · Fort Worth, TX
Provider details
- NPI number
- 1669427290
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
1711 Doolittle Ave
Fort Worth, TX 76179
Phone: (904) 588-2906
Approximate (ZIP-level) locationGet directions
Mailing address
5113 Bayridge Ct
Fort Worth, TX 76179-4255
Registry dates
- Enumerated
- 2006-05-23
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.