| Medical Associates Of Fort Worth Pllc | |
|
412 Mercedes St Ste G Benbrook TX 76126-2558 | |
| (817) 782-9020 | |
| Not Available |
| Full Name | Medical Associates Of Fort Worth Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 412 Mercedes St Ste G, Benbrook, Texas |
| Authorized Official Name and Position | Anwarullah Mohammed (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8177829020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Associates Of Fort Worth Pllc 412 Mercedes St Ste G Benbrook TX 76126-2558 Ph: (817) 782-9020 | Medical Associates Of Fort Worth Pllc 412 Mercedes St Ste G Benbrook TX 76126-2558 Ph: (817) 782-9020 |
| NPI Number | 1972007748 |
|---|---|
| Provider Enumeration Date | 03/19/2018 |
| Last Update Date | 01/22/2019 |
| Medicare PECOS PAC ID | 4880941038 |
|---|---|
| Medicare Enrollment ID | O20180719002038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972007748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Anwarullah Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295021764 PECOS PAC ID: 5991931644 Enrollment ID: I20131202001057 |
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