| Child Study Center | |
|
1300 W Lancaster Ave Fort Worth TX 76102-3410 | |
| (817) 390-2904 | |
| (817) 390-2901 |
| Full Name | Child Study Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1300 W Lancaster Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Cory R Rhoades (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6828854480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Study Center 1300 W Lancaster Ave Fort Worth TX 76102-3410 Ph: (817) 390-2904 | Child Study Center 1300 W Lancaster Ave Fort Worth TX 76102-3410 Ph: (817) 390-2904 |
| NPI Number | 1467621045 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 12/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467621045 | NPI | - | NPPES |
| 091294102 | Medicaid | TX | |
| 189125101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 22961 (Texas) | Primary |
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