Livingspring Family Medical Center Pllc | |
3807 E Broad St Ste 101 Mansfield TX 76063-5623 | |
(817) 717-9597 | |
(833) 992-1938 |
Full Name | Livingspring Family Medical Center Pllc |
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Speciality | Family Medicine |
Location | 3807 E Broad St Ste 101, Mansfield, Texas |
Authorized Official Name and Position | Tolulope Olabintan (OWNER) |
Authorized Official Contact | 2676407762 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Livingspring Family Medical Center Pllc 3807 E Broad St Ste 101 Mansfield TX 76063-5623 Ph: (817) 717-9597 | Livingspring Family Medical Center Pllc 3807 E Broad St Ste 101 Mansfield TX 76063-5623 Ph: (817) 717-9597 |
NPI Number | 1043813603 |
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Provider Enumeration Date | 11/17/2020 |
Last Update Date | 10/18/2021 |
Medicare PECOS PAC ID | 4688087224 |
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Medicare Enrollment ID | O20201229000407 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043813603 | NPI | - | NPPES |
184418001 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Tolulope Mary Olabintan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558686105 PECOS PAC ID: 6103018833 Enrollment ID: I20191023001441 |
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