| Arlington Family Health Pavilion, Pa | |
|
707 N Fielder Rd #a Arlington TX 76012 | |
| (817) 277-2671 | |
| (817) 460-3004 |
| Full Name | Arlington Family Health Pavilion, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 707 N Fielder Rd, Arlington, Texas |
| Authorized Official Name and Position | Jill Melanie Breaux (BUSINESS MGR) |
| Authorized Official Contact | 8172772671 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arlington Family Health Pavilion, Pa 707 N Fielder Rd #a Arlington TX 76012-4636 Ph: (817) 277-2671 | Arlington Family Health Pavilion, Pa 707 N Fielder Rd #a Arlington TX 76012 Ph: (817) 277-2671 |
| NPI Number | 1992764369 |
|---|---|
| Provider Enumeration Date | 03/22/2006 |
| Last Update Date | 10/26/2010 |
| Medicare PECOS PAC ID | 7113903089 |
|---|---|
| Medicare Enrollment ID | O20040629001607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992764369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Texas) | Primary |
| 207R00000X | Internal Medicine | (Texas) | Secondary |
| Provider Name | Mark A Rodgers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811954936 PECOS PAC ID: 8820077357 Enrollment ID: I20040717000040 |
| Provider Name | Gilbert Ledesma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720045842 PECOS PAC ID: 7618956152 Enrollment ID: I20040717000067 |
| Provider Name | Tori L Ledesma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629306428 PECOS PAC ID: 1456492677 Enrollment ID: I20100111000497 |
| Provider Name | Nancy B Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164718003 PECOS PAC ID: 9234309097 Enrollment ID: I20110902000603 |
| Provider Name | Melissa B Rybak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033632526 PECOS PAC ID: 2062821424 Enrollment ID: I20210514001750 |
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