| Elite Health Center | |
|
3418 N Tarrant Pkwy Ste 310 Fort Worth TX 76177-8645 | |
| (817) 562-2339 | |
| (817) 562-1342 |
| Full Name | Elite Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3418 N Tarrant Pkwy Ste 310, Fort Worth, Texas |
| Authorized Official Name and Position | Michael L Bailey (PRESIDENT) |
| Authorized Official Contact | 8175622339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Health Center 3418 N Tarrant Pkwy Ste 310 Fort Worth TX 76177-8645 Ph: (817) 562-2339 | Elite Health Center 3418 N Tarrant Pkwy Ste 310 Fort Worth TX 76177-8645 Ph: (817) 562-2339 |
| NPI Number | 1194962191 |
|---|---|
| Provider Enumeration Date | 01/13/2009 |
| Last Update Date | 01/11/2023 |
| Medicare PECOS PAC ID | 7719034461 |
|---|---|
| Medicare Enrollment ID | O20090415000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194962191 | NPI | - | NPPES |
| 201660202 | Medicaid | TX | |
| 130929605 | Medicaid | TX | |
| 201660201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | K5446 (Texas) | Primary |
| Provider Name | Michael L Bailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215931639 PECOS PAC ID: 5890724926 Enrollment ID: I20070507000593 |
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