| The Oaks Life Center, Pllc | |
|
6012 Reef Point Ln Suite C Fort Worth TX 76135-7008 | |
| (682) 312-8184 | |
| (817) 238-1232 |
| Full Name | The Oaks Life Center, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 6012 Reef Point Ln, Fort Worth, Texas |
| Authorized Official Name and Position | Julie B Cosgrove (CREDENTIALING) |
| Authorized Official Contact | 6822095662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Oaks Life Center, Pllc 6012 Reef Point Ln Ste C Fort Worth TX 76135-2056 Ph: (682) 312-8184 | The Oaks Life Center, Pllc 6012 Reef Point Ln Suite C Fort Worth TX 76135-7008 Ph: (682) 312-8184 |
| NPI Number | 1588036370 |
|---|---|
| Provider Enumeration Date | 10/20/2015 |
| Last Update Date | 04/04/2019 |
| Medicare PECOS PAC ID | 3173862182 |
|---|---|
| Medicare Enrollment ID | O20190410001073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588036370 | NPI | - | NPPES |
| Provider Name | Debra P Mattocks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346307857 PECOS PAC ID: 6204932411 Enrollment ID: I20070504000317 |
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