| Dr Kevin Len Wacasey, MD | |
|
6400 Colleyville Blvd, Colleyville, TX 76034-6444 | |
| (817) 416-6111 | |
| (866) 929-9602 |
| Full Name | Dr Kevin Len Wacasey |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 6400 Colleyville Blvd, Colleyville, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902825946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | K3519 (Texas) | Secondary |
| 208D00000X | General Practice | K3519 (Texas) | Primary |
| Entity Name | Concord Medical Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083630610 PECOS PAC ID: 0446296818 Enrollment ID: O20050707000531 |
| Entity Name | Concord Medical Group Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750790762 PECOS PAC ID: 7810117223 Enrollment ID: O20141007002567 |
| Entity Name | Health And Human Services Commission |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356414692 PECOS PAC ID: 2163795824 Enrollment ID: O20170908001058 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kevin Len Wacasey, MD 6400 Colleyville Blvd, Colleyville, TX 76034-6444 Ph: (817) 416-6111 | Dr Kevin Len Wacasey, MD 6400 Colleyville Blvd, Colleyville, TX 76034-6444 Ph: (817) 416-6111 |
Dr. Lawrence Steven Fox, MD General Practice Medicare: Medicare Enrolled Practice Location: 2604 Highland Park Ct, Colleyville, TX 76034 Phone: 817-354-0699 |