| Citimed, P.a. | |
|
4401 Little Rd Ste 520 Arlington TX 76016-5621 | |
| (817) 572-9890 | |
| (817) 572-9887 |
| Full Name | Citimed, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 4401 Little Rd Ste 520, Arlington, Texas |
| Authorized Official Name and Position | Pohn Paul Inthanousay (OWNER) |
| Authorized Official Contact | 8175729890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Citimed, P.a. 4401 Little Rd Ste 520 Arlington TX 76016-5621 Ph: (817) 572-9890 | Citimed, P.a. 4401 Little Rd Ste 520 Arlington TX 76016-5621 Ph: (817) 572-9890 |
| NPI Number | 1487823316 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 06/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487823316 | NPI | - | NPPES |
| 8H8600 | Other | TX | BLUECROSS AND BLUESHIELD |
| 139893530 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J9103 (Texas) | Primary |
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