| Soul Foundation Inc | |
|
1111 5th Ave Fort Worth TX 76104-4302 | |
| (702) 722-7177 | |
| Not Available |
| Full Name | Soul Foundation Inc |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 1111 5th Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Rick Saga (PRESIDENT) |
| Authorized Official Contact | 9015017242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Foundation Inc 4940 N Tarrant Pkwy Fort Worth TX 76244-5433 Ph: () - | Soul Foundation Inc 1111 5th Ave Fort Worth TX 76104-4302 Ph: (702) 722-7177 |
| NPI Number | 1265149892 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 11/02/2022 |
| Certification Date | 11/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265149892 | NPI | - | NPPES |
| 804566904 | Other | TX | FILE NUMBER SECRETARY OF STATE |
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