| Ethan Tang, MD | |
|
815 Pennsylvania Ave, Fort Worth, TX 76104-2294 | |
| (817) 321-0404 | |
| Not Available |
| Full Name | Ethan Tang |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 7 Years |
| Location | 815 Pennsylvania Ave, Fort Worth, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366948721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 58735 (Arizona) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | V7079 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St. Joseph's Hospital And Medical Center | Phoenix, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Smi Imaging Llc | 3476696220 | 255 |
| Sjhmc Physician Services | 4486646197 | 635 |
| Entity Name | Sjhmc Physician Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326098005 PECOS PAC ID: 4486646197 Enrollment ID: O20040401001189 |
| Entity Name | Smi Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972004489 PECOS PAC ID: 3476696220 Enrollment ID: O20180829003142 |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan Tang, MD 1320 S University Dr Ste 500, Fort Worth, TX 76107-5732 Ph: (817) 321-0404 | Ethan Tang, MD 815 Pennsylvania Ave, Fort Worth, TX 76104-2294 Ph: (817) 321-0404 |
Kelly C Starkey, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 Fax: 469-522-6889 | |
Dr. Mark Sohner, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 173-210-4048 | |
Dr. John A Queralt, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0312 Fax: 817-317-7033 | |
Dr. Robert Joseph Reeb Jr., MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0312 Fax: 817-317-7033 | |
Eugenia Payne, M.D Radiology Medicare: Medicare Enrolled Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 | |
Dr. Jeffrey Scott Wenzel, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0387 | |
Dr. Robert Lewis Emery, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 |