Leon S Tio Md Pa | |
800 8th Ave Ste 506 Fort Worth TX 76104-2604 | |
(817) 386-2679 | |
(817) 386-3632 |
Full Name | Leon S Tio Md Pa |
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Speciality | Internal Medicine |
Location | 800 8th Ave Ste 506, Fort Worth, Texas |
Authorized Official Name and Position | Elaine Phuah (MEDICAL DOCTOR) |
Authorized Official Contact | 2143367643 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Leon S Tio Md Pa 800 8th Ave Ste 506 Fort Worth TX 76104-2604 Ph: (817) 386-3632 | Leon S Tio Md Pa 800 8th Ave Ste 506 Fort Worth TX 76104-2604 Ph: (817) 386-2679 |
NPI Number | 1023581006 |
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Provider Enumeration Date | 01/02/2019 |
Last Update Date | 01/10/2023 |
Medicare PECOS PAC ID | 4880929140 |
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Medicare Enrollment ID | O20190710000608 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023581006 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Elaine I Phuah |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366719767 PECOS PAC ID: 3173756624 Enrollment ID: I20140507001471 |
Provider Name | Leon Siu Tio |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952741795 PECOS PAC ID: 1759677271 Enrollment ID: I20160909001480 |
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