| Wisdom Healthcare Clinic N Healthcare Services Inc | |
|
403 W Main St Suite B Lewisville TX 75057-3757 | |
| (817) 200-6189 | |
| (469) 464-4398 |
| Full Name | Wisdom Healthcare Clinic N Healthcare Services Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 403 W Main St, Lewisville, Texas |
| Authorized Official Name and Position | Michael A Badejo (DIRECTOR) |
| Authorized Official Contact | 9724361811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisdom Healthcare Clinic N Healthcare Services Inc 403 W Main St Suite B Lewisville TX 75057-3757 Ph: (817) 200-6189 | Wisdom Healthcare Clinic N Healthcare Services Inc 403 W Main St Suite B Lewisville TX 75057-3757 Ph: (817) 200-6189 |
| NPI Number | 1013176114 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 01/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013176114 | NPI | - | NPPES |
| 198899001 | Medicaid | TX | |
| 1067786 | Other | TX | NCCPA |
| PA04564 | Other | TX | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PA04564 (Texas) | Primary |
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