| Fort Worth Physicians Pllc | |
|
6201 Overton Ridge Blvd Fort Worth TX 76132-3613 | |
| (203) 224-8568 | |
| Not Available |
| Full Name | Fort Worth Physicians Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6201 Overton Ridge Blvd, Fort Worth, Texas |
| Authorized Official Name and Position | Vishnu Ilineni (OWNER) |
| Authorized Official Contact | 2032248568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Worth Physicians Pllc 400 Montpelier Dr Southlake TX 76092-1335 Ph: () - | Fort Worth Physicians Pllc 6201 Overton Ridge Blvd Fort Worth TX 76132-3613 Ph: (203) 224-8568 |
| NPI Number | 1568248987 |
|---|---|
| Provider Enumeration Date | 09/01/2023 |
| Last Update Date | 09/01/2023 |
| Medicare PECOS PAC ID | 2163878182 |
|---|---|
| Medicare Enrollment ID | O20231027001504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568248987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Vishnu Ilineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033413307 PECOS PAC ID: 7113151978 Enrollment ID: I20200917000436 |
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