FELIZ FAMILY MEDICAL CLINIC PLLC NPI 1013568914

NPI Information

FELIZ FAMILY MEDICAL CLINIC PLLC is a primary care clinic center in Fort Worth, TX. FELIZ FAMILY MEDICAL CLINIC PLLC NPI is 1013568914. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3109 6TH AVE
FORT WORTH, TX
ZIP 76110-800
Phone: (817) 923-7055
Fax: (817) 923-7902

The provider's authorized official is Seema Mottackal George .
The authorized official title is Owner and has the following contact phone number (972) 965-9402.

The CLIA number assigned to this NPI record is 45D2238046 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/23/2019 and was last updated on 9/23/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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