Texas Health Care, P.l.l.c. | |
1209 College Ave. Fort Worth TX 76104-4516 | |
(817) 348-9569 | |
(817) 348-9579 |
Full Name | Texas Health Care, P.l.l.c. |
---|---|
Speciality | Family Medicine |
Location | 1209 College Ave., Fort Worth, Texas |
Authorized Official Name and Position | Larry D. Tatum (C.E.O.) |
Authorized Official Contact | 8177408400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Texas Health Care, P.l.l.c. P.o. Box 961205 Fort Worth TX 76161-1205 Ph: (817) 740-8400 | Texas Health Care, P.l.l.c. 1209 College Ave. Fort Worth TX 76104-4516 Ph: (817) 348-9569 |
NPI Number | 1285782383 |
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Provider Enumeration Date | 01/08/2007 |
Last Update Date | 07/02/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285782383 | NPI | - | NPPES |
155109501 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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