| Clinica Hispana | |
|
3305 Miller Ave Fort Worth TX 76119-1956 | |
| (682) 253-8204 | |
| Not Available |
| Full Name | Clinica Hispana |
|---|---|
| Speciality | Internal Medicine |
| Location | 3305 Miller Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Jonathon Ingram (CHIEF MARKETING OFFICER) |
| Authorized Official Contact | 8323501778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Hispana Po Box 339 Holland TX 76534-0339 Ph: (512) 487-5556 | Clinica Hispana 3305 Miller Ave Fort Worth TX 76119-1956 Ph: (682) 253-8204 |
| NPI Number | 1740865922 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 06/23/2022 |
| Certification Date | 06/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740865922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
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