Jeffery K Hawkins, Md, Pllc | |
7148 Trail Lake Dr Fort Worth TX 76123-1969 | |
(817) 294-0934 | |
(817) 294-1488 |
Full Name | Jeffery K Hawkins, Md, Pllc |
---|---|
Speciality | Family Medicine |
Location | 7148 Trail Lake Dr, Fort Worth, Texas |
Authorized Official Name and Position | Jeffery K Hawkins (PROVIDER/OWNER) |
Authorized Official Contact | 8172940934 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jeffery K Hawkins, Md, Pllc 7148 Trail Lake Dr Fort Worth TX 76123-1969 Ph: (817) 294-0934 | Jeffery K Hawkins, Md, Pllc 7148 Trail Lake Dr Fort Worth TX 76123-1969 Ph: (817) 294-0934 |
NPI Number | 1316430580 |
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Provider Enumeration Date | 06/12/2018 |
Last Update Date | 05/16/2019 |
Medicare PECOS PAC ID | 5799036950 |
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Medicare Enrollment ID | O20180927000140 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316430580 | NPI | - | NPPES |
Q3197 | Other | TX | SPORTS MEDICINE/PAIN MANAGEMENT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QS0010X | Family Medicine - Sports Medicine | Q3197 (Texas) | Primary |
Provider Name | Jeffery K Hawkins |
---|---|
Provider Type | Practitioner - Sports Medicine |
Provider Identifiers | NPI Number: 1609175843 PECOS PAC ID: 8123336559 Enrollment ID: I20151003000012 |
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