Provider Demographics
NPI:1538264239
Name:MESSER, LARRY D (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:D
Last Name:MESSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-4405
Practice Address - Fax:682-885-4407
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9569207X00000X, 207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138412510Medicaid
1750369203OtherGRP NPI NUMBER
TX00U87ZOtherBCBSTX GRP PIN
TX110183404Medicaid
TX128236OtherUHC PIN
TX142204001Medicaid
TX10028626OtherAMERIGROUP PIN
TX4615156OtherCIGNA PIN
TX4366726OtherAETNA PIN
TX119370100OtherFIRSTCARE PIN
TX138412503Medicaid
TX88890XOtherBCBSTX IND PIN
TX00U87ZOtherMEDICARE GROUP PIN
TX124169OtherSUPERIOR PIN
TX730039OtherFIRSTHEALTH PIN
TX4615156OtherCIGNA PIN
TX142204001Medicaid