Chanida K Supavong, DO in Fort Worth, TX - Medicare Family Medicine

Chanida K Supavong, DO is a medicare enrolled "Family Medicine" physician in Fort Worth, Texas. Her current practice location is 5450 Clearfork Main St Ste 460, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 423-5121.

Chanida K Supavong is licensed to practice in Texas (license number P5896) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750672218.

Contact Information

	Chanida K Supavong, DO
	5450 Clearfork Main St Ste 460, Fort Worth, TX 76109
	(817) 423-5121
	(817) 423-5122

Map and Direction

Physician's Profile

Full Name	Chanida K Supavong
Gender	Female
Speciality	Family Medicine
Location	5450 Clearfork Main St Ste 460, Fort Worth, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750672218
Provider Enumeration Date: 05/02/2011
Last Update Date: 07/25/2018

Medicare PECOS Information:

PECOS PAC ID: 1951538867
Enrollment ID: I20131223000993

Medical Identifiers

Medical identifiers for Chanida K Supavong such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750672218	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	P5896 (Texas)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Chanida K Supavong is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Chanida K Supavong, DO 5450 Clearfork Main St Ste 460, Fort Worth, TX 76109-3560 Ph: (817) 423-5121	Chanida K Supavong, DO 5450 Clearfork Main St Ste 460, Fort Worth, TX 76109 Ph: (817) 423-5121

Reviews and Comments

Family Medicine Doctors in Fort Worth, TX

Jonathan A Lazarini, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1500 S Main St, Fort Worth, TX 76104 Phone: 903-353-2265
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Dr. Joane Baumer, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1500 S Main St, Family Medicine Center, Fort Worth, TX 76104 Phone: 817-335-1034
Evelyn Tobias-merrill, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2825 Stadium Dr, Fort Worth, TX 76109 Phone: 817-257-7940
Dr. Michael David Carletti, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 855 Montgomery St, Fort Worth, TX 76107 Phone: 817-735-0278
Jonathan Patrick Angel, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 N Beach St Ste 104, Fort Worth, TX 76111 Phone: 817-831-1750 Fax: 817-831-1750

Chanida K Supavong, DO - Medicare Family Medicine in Fort Worth, TX