Rockwood Medical Clinic, P.a. | |
1217 Grand Ave Fort Worth TX 76106-9041 | |
(817) 625-7733 | |
(817) 740-1602 |
Full Name | Rockwood Medical Clinic, P.a. |
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Speciality | Family Medicine |
Location | 1217 Grand Ave, Fort Worth, Texas |
Authorized Official Name and Position | Michele Lee Garza (OFFICE MANAGER) |
Authorized Official Contact | 8176257733 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rockwood Medical Clinic, P.a. Po Box 4705 Fort Worth TX 76164-0705 Ph: (817) 625-7733 | Rockwood Medical Clinic, P.a. 1217 Grand Ave Fort Worth TX 76106-9041 Ph: (817) 625-7733 |
NPI Number | 1033311857 |
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Provider Enumeration Date | 06/04/2007 |
Last Update Date | 06/30/2010 |
Medicare PECOS PAC ID | 8628137551 |
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Medicare Enrollment ID | O20081107000192 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033311857 | NPI | - | NPPES |
8J1230 | Other | TX | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H0411 (Texas) | Primary |
Provider Name | Alex Guevara |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699768481 PECOS PAC ID: 0446319271 Enrollment ID: I20120514000704 |
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