| Old Town Family Practice Pa | |
|
413 W. Bethel Rd Ste 300 Coppell TX 75019-4402 | |
| (972) 393-4726 | |
| (972) 393-4850 |
| Full Name | Old Town Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 413 W. Bethel Rd, Coppell, Texas |
| Authorized Official Name and Position | Steven A. Swaldi (PHYSICIAN OWNER) |
| Authorized Official Contact | 9723934726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Town Family Practice Pa 413 W. Bethel Rd Ste 300 Coppell TX 75019-4402 Ph: (972) 393-4726 | Old Town Family Practice Pa 413 W. Bethel Rd Ste 300 Coppell TX 75019-4402 Ph: (972) 393-4726 |
| NPI Number | 1487757571 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 07/10/2008 |
| Medicare PECOS PAC ID | 7315945755 |
|---|---|
| Medicare Enrollment ID | O20061120000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487757571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steven A Swaldi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639150535 PECOS PAC ID: 7214935659 Enrollment ID: I20061120000540 |
| Provider Name | Margaret A Cusack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902929987 PECOS PAC ID: 8325130818 Enrollment ID: I20070904000622 |
| Provider Name | Carol K Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114095536 PECOS PAC ID: 2860665064 Enrollment ID: I20111103000674 |
| Provider Name | Brittany L Frantz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518489525 PECOS PAC ID: 6305252958 Enrollment ID: I20210308000642 |
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