2017 Fwuc Medical Professionals PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

2017 FWUC MEDICAL PROFESSIONALS PLLC

Practice address

601 Northwest Pkwy Ste C
Azle, TX 76020-2930

Phone

(817) 270-0777

Fax

(817) 421-0036

NPI assigned

Sep 8, 2017

Last updated

Sep 8, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Braxton Neiman

Title

General Counsel

Phone

(817) 421-0034

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1992223085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S KIMBALL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929016",
            "telephone_number": "817-527-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NORTHWEST PKWY STE C",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202930",
            "telephone_number": "817-270-0777",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2017 FWUC MEDICAL PROFESSIONALS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "NEIMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRAXTON",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "817-421-0034",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delvin Eugene Aaron, R.PH.
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• Hannah Allen, M.S. CCC-SLP

• Family Medicine Physician in Azle, TX
• Providers in Azle, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.