| Beach Medical Clinic | |
|
1413 N Beach St Fort Worth TX 76111-6614 | |
| (817) 831-0034 | |
| Not Available |
| Full Name | Beach Medical Clinic |
|---|---|
| Speciality | General Practice |
| Location | 1413 N Beach St, Fort Worth, Texas |
| Authorized Official Name and Position | Bao Vinh Nguyen-phuc (OWNER) |
| Authorized Official Contact | 8178310034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Medical Clinic 1413 N Beach St Fort Worth TX 76111-6614 Ph: () - | Beach Medical Clinic 1413 N Beach St Fort Worth TX 76111-6614 Ph: (817) 831-0034 |
| NPI Number | 1740685494 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 10/23/2014 |
| Medicare PECOS PAC ID | 3870819345 |
|---|---|
| Medicare Enrollment ID | O20150226001923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740685494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | K8667 (Texas) | Primary |
| Provider Name | Bao V Nguyen Phuc |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518094317 PECOS PAC ID: 0042110249 Enrollment ID: I20040114000246 |
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