Extra Care Concerns | |
2529 E Lancaster Ave Ste A Fort Worth TX 76103-2253 | |
(817) 534-7300 | |
Not Available |
Full Name | Extra Care Concerns |
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Speciality | Family Medicine |
Location | 2529 E Lancaster Ave Ste A, Fort Worth, Texas |
Authorized Official Name and Position | Patricia L Roberts (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 8175347300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Extra Care Concerns 2529 E Lancaster Ave Ste A Fort Worth TX 76103-2253 Ph: (817) 534-7300 | Extra Care Concerns 2529 E Lancaster Ave Ste A Fort Worth TX 76103-2253 Ph: (817) 534-7300 |
NPI Number | 1366940470 |
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Provider Enumeration Date | 01/24/2018 |
Last Update Date | 06/16/2018 |
Medicare PECOS PAC ID | 5092073817 |
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Medicare Enrollment ID | O20180215002100 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366940470 | NPI | - | NPPES |
L1186 | Other | TX | MEDICAL LIC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | L1186 (Texas) | Primary |
Provider Name | Patricia L Roberts |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053382846 PECOS PAC ID: 6204808702 Enrollment ID: I20040806000138 |
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