| Thaddeus Opalach Do Pa | |
|
990 N Walnut Creek Dr Suite 2014 Mansfield TX 76063-1580 | |
| (817) 453-2223 | |
| (817) 453-2269 |
| Full Name | Thaddeus Opalach Do Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 990 N Walnut Creek Dr, Mansfield, Texas |
| Authorized Official Name and Position | Thaddeus G Opalach (OWNER) |
| Authorized Official Contact | 8174532223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thaddeus Opalach Do Pa Po Box 938 Killeen TX 76540-0938 Ph: (254) 634-6999 | Thaddeus Opalach Do Pa 990 N Walnut Creek Dr Suite 2014 Mansfield TX 76063-1580 Ph: (817) 453-2223 |
| NPI Number | 1558502773 |
|---|---|
| Provider Enumeration Date | 03/18/2009 |
| Last Update Date | 10/15/2009 |
| Medicare PECOS PAC ID | 1355490202 |
|---|---|
| Medicare Enrollment ID | O20090522000394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558502773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | L8870 (Texas) | Primary |
| Provider Name | Thaddeus G Opalach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598829707 PECOS PAC ID: 6709975865 Enrollment ID: I20071128000169 |
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