| Angel's Star Wellness Center, P.a | |
|
8325 Whitley Rd Suite: 100 Watauga TX 76148-2487 | |
| (817) 479-1181 | |
| (817) 918-4432 |
| Full Name | Angel's Star Wellness Center, P.a |
|---|---|
| Speciality | Family Medicine |
| Location | 8325 Whitley Rd, Watauga, Texas |
| Authorized Official Name and Position | Frank Nguyen (MANAGEMENT) |
| Authorized Official Contact | 8177911811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel's Star Wellness Center, P.a 8325 Whitley Rd Suite: 100 Watauga TX 76148-2487 Ph: (817) 479-1181 | Angel's Star Wellness Center, P.a 8325 Whitley Rd Suite: 100 Watauga TX 76148-2487 Ph: (817) 479-1181 |
| NPI Number | 1457412710 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 10/20/2021 |
| Medicare PECOS PAC ID | 3870675150 |
|---|---|
| Medicare Enrollment ID | O20080124000692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457412710 | NPI | - | NPPES |
| 0072PD | Other | TX | BCBS |
| 191341001 | Medicaid | TX | |
| DH2407 | Other | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L0508 (Texas) | Primary |
| Provider Name | Chau N Pham |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1881659381 PECOS PAC ID: 8022190339 Enrollment ID: I20080125000219 |
| Provider Name | Jennifer Duyen Trinh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770943177 PECOS PAC ID: 2365776622 Enrollment ID: I20190620002691 |
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