Withcare Clinic | |
4157 Bedford Rd Ste 200 Bedford TX 76021-5228 | |
(469) 949-6080 | |
(972) 634-1038 |
Full Name | Withcare Clinic |
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Speciality | Clinic/Center |
Location | 4157 Bedford Rd Ste 200, Bedford, Texas |
Authorized Official Name and Position | Iyen Omoragbon (PRESIDENT AND CLINICAL DIRECTOR) |
Authorized Official Contact | 2146768711 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Withcare Clinic 4157 Bedford Rd Ste 200 Bedford TX 76021-5228 Ph: (469) 949-6080 | Withcare Clinic 4157 Bedford Rd Ste 200 Bedford TX 76021-5228 Ph: (469) 949-6080 |
NPI Number | 1801521786 |
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Provider Enumeration Date | 07/23/2022 |
Last Update Date | 03/28/2024 |
Medicare PECOS PAC ID | 3971968546 |
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Medicare Enrollment ID | O20230504000016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801521786 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Iyen J Omoragbon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275939761 PECOS PAC ID: 4486680493 Enrollment ID: I20160126001753 |
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