2017 Fwuc Medical Professionals PLLC
Organization Active NPI Family Medicine Physician · Azle, TX
NPI 1992223085 · NPPES record last updated Sep 8, 2017
Key facts
- NPI
- 1992223085
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 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
- Organization subpart
- No
Authorized official
- Name
- Mr. John Braxton Neiman
- Title
- General Counsel
- Phone
- (817) 421-0034
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
601 Northwest Pkwy Ste C
Azle, TX 76020-2930
Mailing address
920 S Kimball Ave
Southlake, TX 76092-9016
Phone (817) 527-3403
Other providers in Azle, TX
- Delvin Eugene Aaron
- Accurate Medical Equipment and Supply Co., Inc.
- Kifle Admassu
- Albertsons LLC
- Hannah Allen
All providers in Azle, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.