| North Tarrant Family Practice | |
|
5445 Basswood Blvd Suite 650 Fort Worth TX 76137-4437 | |
| (817) 485-0161 | |
| (817) 485-9430 |
| Full Name | North Tarrant Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 5445 Basswood Blvd, Fort Worth, Texas |
| Authorized Official Name and Position | Robert Allan Hodgson (PRESIDENT) |
| Authorized Official Contact | 8174850161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Tarrant Family Practice 5445 Basswood Blvd Suite 650 Fort Worth TX 76137-4437 Ph: (817) 485-0161 | North Tarrant Family Practice 5445 Basswood Blvd Suite 650 Fort Worth TX 76137-4437 Ph: (817) 485-0161 |
| NPI Number | 1740369073 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7810970951 |
|---|---|
| Medicare Enrollment ID | O20040610000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740369073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G2993 (Texas) | Primary |
| Provider Name | Dana Kirby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730282781 PECOS PAC ID: 3971578758 Enrollment ID: I20040826000915 |
| Provider Name | Robert Allan Hodgson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437252459 PECOS PAC ID: 3971608613 Enrollment ID: I20111128000058 |
| Provider Name | David C Haefeli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639272636 PECOS PAC ID: 6002077005 Enrollment ID: I20120419000137 |
| Provider Name | Sudha R Jogimahanti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649373614 PECOS PAC ID: 9739341405 Enrollment ID: I20120426000225 |
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