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480 W Southlake Blvd Suite 115 Southlake TX 76092 | |
| (817) 416-2221 | |
| (817) 424-5400 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 480 W Southlake Blvd, Southlake, Texas |
| Authorized Official Name and Position | Heather Renee Hardin (OFFICE MANAGER) |
| Authorized Official Contact | 8141622221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
480 W Southlake Blvd Suite 115 Southlake TX 76092 Ph: (817) 416-2221 | 480 W Southlake Blvd Suite 115 Southlake TX 76092 Ph: (817) 416-2221 |
| NPI Number | 1477651826 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477651826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K2373 (Texas) | Primary |
Mediclink Management Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-506-4132 | |
Health Matters Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 River Oaks Drive, #100, Southlake, TX 76092 Phone: 505-220-6814 | |
Southlake Hospitalists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1321 Bay Meadows Dr, Southlake, TX 76092 Phone: 817-521-4747 Fax: 214-279-9273 | |
Global Anesthesia Specialists, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 470 E State Highway 114, Southlake, TX 76092 Phone: 214-450-9926 | |
Modern Medical House Calls Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 855 Davis Blvd Ste 500, Southlake, TX 76092 Phone: 817-912-1771 Fax: 940-241-6156 | |