| Dfw Internal Medicine Clinic, Pllc | |
|
2207 Michigan Ave Arlington TX 76013-5916 | |
| (817) 465-7400 | |
| (817) 704-7057 |
| Full Name | Dfw Internal Medicine Clinic, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2207 Michigan Ave, Arlington, Texas |
| Authorized Official Name and Position | Petua Okolo (OWNER) |
| Authorized Official Contact | 8174657400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfw Internal Medicine Clinic, Pllc 2207 Michigan Ave Arlington TX 76013-5916 Ph: (817) 465-7400 | Dfw Internal Medicine Clinic, Pllc 2207 Michigan Ave Arlington TX 76013-5916 Ph: (817) 465-7400 |
| NPI Number | 1881847861 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 04/11/2013 |
| Medicare PECOS PAC ID | 0941367114 |
|---|---|
| Medicare Enrollment ID | O20090316000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881847861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M0846 (Texas) | Primary |
| Provider Name | Petua A Okolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821023110 PECOS PAC ID: 4284664913 Enrollment ID: I20050812000678 |
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