| North Central Texas Infectious Disease Group Pa | |
|
650 Saint Louis Ave Fort Worth TX 76104-3346 | |
| (817) 921-1886 | |
| Not Available |
| Full Name | North Central Texas Infectious Disease Group Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 650 Saint Louis Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Edward Tomoye (D.O./PRESIDENT) |
| Authorized Official Contact | 8179211886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Central Texas Infectious Disease Group Pa 1169 N Burleson Blvd Suite 107-235 Burleson TX 76028-7011 Ph: (817) 921-1886 | North Central Texas Infectious Disease Group Pa 650 Saint Louis Ave Fort Worth TX 76104-3346 Ph: (817) 921-1886 |
| NPI Number | 1437426723 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 10/02/2013 |
| Medicare PECOS PAC ID | 7416115886 |
|---|---|
| Medicare Enrollment ID | O20120215000395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437426723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Edward O Tomoye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326168386 PECOS PAC ID: 6204094675 Enrollment ID: I20120215000461 |
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