Centro Medical Guadalupe

NPI 1144508458 - Clinic/Center - 261QP2300X

NPI Details
NPI 1144508458
Enumeration Date 08/03/2011
Last Updated 08/03/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name MARYNA MARYNA
Position OFFICE MANAGER
Phone (817) 378-0777
Fax (817) 378-9522
Practice Location
1220 N MAIN ST
FORT WORTH TX, 76164-9168, US
Phone (817) 378-0777
Fax (817) 378-9522
Business Location
1220 N MAIN ST
FORT WORTH TX, 76164-9168, US
Phone (817) 378-0777
Fax
Toxanomy
Taxonomy Code 261QP2300X
License State Texas
License Number H4919
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According to our database, Centro Medical Guadalupe NPI is 1144508458, taxonomy code is 261QP2300X and license number is H4919, license state is located at Texas. Centro Medical Guadalupe physically located at 1220 N Main St, Fort Worth TX, 76164-9168. NPI Number 1033115704 has the healthcare provider type.

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1144508458 NPI number is provided on an as is basis without warranty of any kind. 1144508458 is maintained by the National Plan & Provider Enumeration System. The contents of Centro Medical Guadalupe are for informational purposes only.