| Lisa M Buell, M.d., P.a. | |
|
6250 John Ryan Dr Fort Worth TX 76132-4115 | |
| (817) 346-6266 | |
| (817) 346-1639 |
| Full Name | Lisa M Buell, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 6250 John Ryan Dr, Fort Worth, Texas |
| Authorized Official Name and Position | Lisa M Buell (PRESIDENT) |
| Authorized Official Contact | 8173466266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M Buell, M.d., P.a. 6250 John Ryan Dr Fort Worth TX 76132-4115 Ph: (817) 346-6266 | Lisa M Buell, M.d., P.a. 6250 John Ryan Dr Fort Worth TX 76132-4115 Ph: (817) 346-6266 |
| NPI Number | 1669604088 |
|---|---|
| Provider Enumeration Date | 08/18/2009 |
| Last Update Date | 08/18/2009 |
| Medicare PECOS PAC ID | 8426205345 |
|---|---|
| Medicare Enrollment ID | O20120829000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669604088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J6164 (Texas) | Primary |
| Provider Name | Lisa M Buell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689660557 PECOS PAC ID: 5698815611 Enrollment ID: I20091222000470 |
| Provider Name | Monica A Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700891652 PECOS PAC ID: 7911154844 Enrollment ID: I20120829000345 |
| Provider Name | Andrea E Cheneweth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275548109 PECOS PAC ID: 3971750704 Enrollment ID: I20120829000396 |
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