| Health Texas Provider Network-family Practice Of North Texas Llp | |
|
1001 12th Ave Suite 130 Fort Worth TX 76104-3926 | |
| (817) 921-6166 | |
| (817) 921-9594 |
| Full Name | Health Texas Provider Network-family Practice Of North Texas Llp |
|---|---|
| Speciality | Family Medicine |
| Location | 1001 12th Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Ellen Elizabeth Fourton (DIRECTOR) |
| Authorized Official Contact | 9728608649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Texas Provider Network-family Practice Of North Texas Llp 8080 N Central Expy Suite 1650 Dallas TX 75206-1838 Ph: (972) 860-8653 | Health Texas Provider Network-family Practice Of North Texas Llp 1001 12th Ave Suite 130 Fort Worth TX 76104-3926 Ph: (817) 921-6166 |
| NPI Number | 1114919172 |
|---|---|
| Provider Enumeration Date | 08/16/2005 |
| Last Update Date | 02/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114919172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 00997Y (Texas) | Primary |
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