| Diabetes And Thyroid Center Of Fort Worth, Pllc | |
|
7801 Oakmont Blvd Suite 101 Fort Worth TX 76132-4204 | |
| (817) 263-0007 | |
| (817) 263-1118 |
| Full Name | Diabetes And Thyroid Center Of Fort Worth, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7801 Oakmont Blvd, Fort Worth, Texas |
| Authorized Official Name and Position | Darren Lackan (PRESIDENT) |
| Authorized Official Contact | 8172630007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Thyroid Center Of Fort Worth, Pllc 7801 Oakmont Blvd Suite 101 Fort Worth TX 76132-4204 Ph: (817) 263-0007 | Diabetes And Thyroid Center Of Fort Worth, Pllc 7801 Oakmont Blvd Suite 101 Fort Worth TX 76132-4204 Ph: (817) 263-0007 |
| NPI Number | 1326373143 |
|---|---|
| Provider Enumeration Date | 10/13/2009 |
| Last Update Date | 11/10/2022 |
| Medicare PECOS PAC ID | 5597808584 |
|---|---|
| Medicare Enrollment ID | O20100129000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326373143 | NPI | - | NPPES |
| 209175301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Anjanette Sia Lin Tan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154326627 PECOS PAC ID: 7416936919 Enrollment ID: I20100129000301 |
| Provider Name | Lisa D Mijares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134513401 PECOS PAC ID: 1557689841 Enrollment ID: I20150416002350 |
| Provider Name | Rachel Martha Mansheim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386286037 PECOS PAC ID: 8325370745 Enrollment ID: I20191104001713 |
| Provider Name | Suzanne Sophia Wombough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124634621 PECOS PAC ID: 9739594722 Enrollment ID: I20210225001911 |
| Provider Name | Sara Matani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1629481957 PECOS PAC ID: 1456570498 Enrollment ID: I20221205001145 |
Southwest Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 Bryant Irvin Rd, Suite 203, Fort Worth, TX 76132 Phone: 817-346-4000 Fax: 817-263-9398 | |
University Of North Texas Health Science Center At Fort Worth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 855 Montgomery St, Fort Worth, TX 76107 Phone: 817-735-2000 | |
Hanson Internal Medicine, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6100 Harris Pkwy, Suite 240, Fort Worth, TX 76132 Phone: 817-504-5699 | |
Feliz Family Medical Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3109 6th Ave, Fort Worth, TX 76110 Phone: 817-923-7055 Fax: 817-923-7902 | |
Symetria Health Of Texas, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7229 Hawkins View Dr, Fort Worth, TX 76132 Phone: 682-350-4444 | |
Associates Of Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2260 College Ave, Fort Worth, TX 76110 Phone: 682-268-1152 Fax: 877-772-0063 | |
Apex Alliance Medical Group Lp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2401 Westport Pkwy, Suite 150, Fort Worth, TX 76177 Phone: 817-837-1091 Fax: 817-837-1097 |