| Miracle Works Pllc | |
|
805 Washington Dr Ste D Arlington TX 76011-2528 | |
| (817) 264-6048 | |
| (817) 549-9755 |
| Full Name | Miracle Works Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 805 Washington Dr Ste D, Arlington, Texas |
| Authorized Official Name and Position | Miracle Wagner (CEO/DIRECTOR) |
| Authorized Official Contact | 8172646048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Works Pllc Po Box 201593 Arlington TX 76006-1593 Ph: (817) 264-6048 | Miracle Works Pllc 805 Washington Dr Ste D Arlington TX 76011-2528 Ph: (817) 264-6048 |
| NPI Number | 1942759535 |
|---|---|
| Provider Enumeration Date | 09/24/2016 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942759535 | NPI | - | NPPES |
| 36085501 | Medicaid | TX | |
| 365158001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 72494 (Texas) | Primary |
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