Fort Worth Pediatrics, P.a.
Pediatric Adolescent Medicine
Fort Worth Pediatrics, P.a. is a Fort Worth, Texas based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
1108 S Henderson St, Fort Worth, Texas - 76104-4430. They can be contacted on phone at
817-335-3255 and fax number 817-336-6780.
NPI number (Unique professional ID) for Fort Worth Pediatrics, P.a. is
1972623031 which was assigned by NPPES on 30 Mar, 2007 and it was last updated on 14 Jun, 2011.
Fort Worth Pediatrics, P.a. specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Fort Worth Pediatrics, P.a. basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Fort Worth Pediatrics, P.a. |
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Business Address:
Fort Worth Pediatrics, P.a. address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1108 S Henderson St
Fort Worth, TX, 76104-4430
United States |
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| Phone Number : | 817-335-3255 |
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| Fax Number : | 817-336-6780 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1972623031 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 30 Mar, 2007 |
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| Last Updated On : | 14 Jun, 2011 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Diane Richey |
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| Official Title or Position : | ADMINISTRATOR |
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| Phone Number : | 817-336-4040 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Fort Worth Pediatrics, P.a. are as mentioned. Primary taxonomy code for Fort Worth Pediatrics, P.a. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | TX |
Legacy Identifiers:
Other legacy medical identifiers of Fort Worth Pediatrics, P.a. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 00L72L | Other | TX | BCBS |
| 130900703 | Other | TX | MEDICAID EPSDT |
| 130900702 | MEDICAID | TX | |
| 10001409 | Other | TX | AMERIGROUP |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 5708 Edwards Ranch Road
Fort Worth, TX, 76109
United States |
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| Phone Number : | 817-336-4040 |
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| Fax Number : | 817-336-6780 |
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Business Location:
Patients can refer following map for directions to
Fort Worth Pediatrics, P.a. practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.