| Hisham Bismar Md Pa | |
|
11807 South Freeway, Ste 362 Fort Worth TX 76115 | |
| (817) 568-0004 | |
| (817) 568-0804 |
| Full Name | Hisham Bismar Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 11807 South Freeway, Ste 362, Fort Worth, Texas |
| Authorized Official Name and Position | Hisham Bismar (MEDICAL DOCTOR/OWNER) |
| Authorized Official Contact | 8175680004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hisham Bismar Md Pa 11807 South Freeway, Ste 362 Fort Worth TX 76115 Ph: (817) 568-0004 | Hisham Bismar Md Pa 11807 South Freeway, Ste 362 Fort Worth TX 76115 Ph: (817) 568-0004 |
| NPI Number | 1912194135 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 01/11/2011 |
| Medicare PECOS PAC ID | 6800823527 |
|---|---|
| Medicare Enrollment ID | O20050725000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912194135 | NPI | - | NPPES |
| 0052BD | Other | TX | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Texas) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | (Texas) | Primary |
| Provider Name | Hisham Bismar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1154371078 PECOS PAC ID: 2062449788 Enrollment ID: I20100610000760 |
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