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1800 N Britain Rd Irving TX 75061-2630 | |
| (214) 266-3204 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1800 N Britain Rd, Irving, Texas |
| Authorized Official Name and Position | Frederick P. Cerise (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2145908006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 660599 Dallas TX 75266-0599 Ph: () - | 1800 N Britain Rd Irving TX 75061-2630 Ph: (214) 266-3204 |
| NPI Number | 1326296617 |
|---|---|
| Provider Enumeration Date | 08/29/2008 |
| Last Update Date | 12/12/2022 |
| Certification Date | 12/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326296617 | NPI | - | NPPES |
| 195489301 | Medicaid | TX |
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