| Core Medical Associates Pllc | |
|
6001 Harris Pkwy Fort Worth TX 76132-4103 | |
| (817) 370-6350 | |
| (817) 370-6401 |
| Full Name | Core Medical Associates Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6001 Harris Pkwy, Fort Worth, Texas |
| Authorized Official Name and Position | Lee Hartman (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8173706350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Medical Associates Pllc 6001 Harris Pkwy Fort Worth TX 76132-4103 Ph: (817) 370-6350 | Core Medical Associates Pllc 6001 Harris Pkwy Fort Worth TX 76132-4103 Ph: (817) 370-6350 |
| NPI Number | 1982476651 |
|---|---|
| Provider Enumeration Date | 10/26/2023 |
| Last Update Date | 10/26/2023 |
| Medicare PECOS PAC ID | 4183075674 |
|---|---|
| Medicare Enrollment ID | O20240109003153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982476651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Ensou Liang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437155751 PECOS PAC ID: 7719171891 Enrollment ID: I20101102001409 |
| Provider Name | Paul B Bourland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790101624 PECOS PAC ID: 0446573489 Enrollment ID: I20141229000123 |
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