Linda K Phan, MD | |
252 Matlock Rd Ste 300, Mansfield, TX 76063-4294 | |
(817) 557-5473 | |
(817) 539-0476 |
Full Name | Linda K Phan |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 252 Matlock Rd Ste 300, Mansfield, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235245895 | NPI | - | NPPES |
184093605 | Medicaid | TX | |
1669442042 | Other | GRP NPI NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | TEMPLP (Texas) | Secondary |
208000000X | Pediatrics | M4914 (Texas) | Primary |
Entity Name | Medical Clinic Of North Texas, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033167234 PECOS PAC ID: 9830084540 Enrollment ID: O20040430001258 |
Entity Name | Dallas Physician Medical Services For Children Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194153650 PECOS PAC ID: 1759607906 Enrollment ID: O20150305000673 |
Mailing Address | Practice Location Address |
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Linda K Phan, MD 252 Matlock Rd Ste 300, Mansfield, TX 76063-4294 Ph: (817) 557-5473 | Linda K Phan, MD 252 Matlock Rd Ste 300, Mansfield, TX 76063-4294 Ph: (817) 557-5473 |
Katrina L Willie-musoma, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2800 E Broad St Ste 100, Mansfield, TX 76063 Phone: 817-557-5437 Fax: 817-539-0476 | |
Clive G Daniels, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 Fax: 817-453-2714 | |
Dr. Naima Garrett, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1759 Broad Park Cir S Ste 201, Mansfield, TX 76063 Phone: 682-341-3910 Fax: 682-400-1288 | |
Matthew Raymond Lussier, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 | |
Melvin T Joki, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 Fax: 817-453-2714 | |
Robert W Mann, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 Fax: 817-453-2714 |