| West Park Clinic | |
|
1106 W Randol Mill Rd Arlington TX 76012-6506 | |
| (817) 277-4441 | |
| Not Available |
| Full Name | West Park Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1106 W Randol Mill Rd, Arlington, Texas |
| Authorized Official Name and Position | Nathan D Hale (PRESIDENT) |
| Authorized Official Contact | 8172774441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Park Clinic 912 Wright St Suite D Arlington TX 76012-4759 Ph: (817) 277-4441 | West Park Clinic 1106 W Randol Mill Rd Arlington TX 76012-6506 Ph: (817) 277-4441 |
| NPI Number | 1265503957 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265503957 | NPI | - | NPPES |
| 75-1289579 | Other | TX | TAX IDENTIFICATION NUMBER |
| 0001GF | Other | TX | BLUE CROSS BLUE SHIELD TX |
| 082969901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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