Tristan's Legacy, Pllc | |
1751 River Run Ste 200 Fort Worth TX 76107-6670 | |
(682) 708-0500 | |
Not Available |
Full Name | Tristan's Legacy, Pllc |
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Speciality | Counselor - Professional |
Location | 1751 River Run Ste 200, Fort Worth, Texas |
Authorized Official Name and Position | Edward Towns (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5129759547 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tristan's Legacy, Pllc 6075 Monte Vista Ln Apt 1621 Fort Worth TX 76132-5436 Ph: (512) 975-9547 | Tristan's Legacy, Pllc 1751 River Run Ste 200 Fort Worth TX 76107-6670 Ph: (682) 708-0500 |
NPI Number | 1922621796 |
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Provider Enumeration Date | 05/27/2020 |
Last Update Date | 05/27/2020 |
Certification Date | 05/27/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922621796 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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