| Careatc - Vistra Glen Rose TX | |
|
6322 S Fm 56 Glen Rose TX 76043-6471 | |
| (817) 260-0836 | |
| Not Available |
| Full Name | Careatc - Vistra Glen Rose TX |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 6322 S Fm 56, Glen Rose, Texas |
| Authorized Official Name and Position | Kelly Bender (SR. DIRECTOR, DATA & ANALYTICS) |
| Authorized Official Contact | 9187797475 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Careatc - Vistra Glen Rose TX 4500 S 129th East Ave Tulsa OK 74134-5801 | Careatc - Vistra Glen Rose TX 6322 S Fm 56 Glen Rose TX 76043-6471 Ph: (817) 260-0836 |
| NPI Number | 1447069398 |
|---|---|
| Provider Enumeration Date | 01/06/2025 |
| Last Update Date | 01/06/2025 |
| Certification Date | 01/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447069398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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