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6619 Forest Hill Dr Suite 30 Forest Hill TX 76140-1260 | |
(817) 563-6985 | |
(817) 563-4064 |
Full Name | |
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Speciality | Clinic/Center |
Location | 6619 Forest Hill Dr, Forest Hill, Texas |
Authorized Official Name and Position | Stephanie Ifeoma Menes (OWNER) |
Authorized Official Contact | 8175636985 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6619 Forest Hill Drive 30 Forest Hill TX 76140-1260 Ph: (817) 563-6985 | 6619 Forest Hill Dr Suite 30 Forest Hill TX 76140-1260 Ph: (817) 563-6985 |
NPI Number | 1467781138 |
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Provider Enumeration Date | 12/09/2009 |
Last Update Date | 01/29/2020 |
Medicare PECOS PAC ID | 4284062886 |
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Medicare Enrollment ID | O20200313000941 |
Identifier | Type | State | Issuer |
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1467781138 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | N1764 (Texas) | Primary |
Provider Name | Stephanie I Menes |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528204997 PECOS PAC ID: 8123184819 Enrollment ID: I20090304000654 |