| Clover Internal Medicine Associates | |
|
800 8th Ave Ste 506 Fort Worth TX 76104-2604 | |
| (817) 386-2679 | |
| (817) 386-3632 |
| Full Name | Clover Internal Medicine Associates |
|---|---|
| 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 |
|---|---|
| Clover Internal Medicine Associates 800 8th Ave Ste 506 Fort Worth TX 76104-2604 Ph: (817) 386-3632 | Clover Internal Medicine Associates 800 8th Ave Ste 506 Fort Worth TX 76104-2604 Ph: (817) 386-2679 |
| NPI Number | 1023581006 |
|---|---|
| Provider Enumeration Date | 01/02/2019 |
| Last Update Date | 01/10/2023 |
| Medicare PECOS PAC ID | 4880929140 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366719767 PECOS PAC ID: 3173756624 Enrollment ID: I20140507001471 |
| Provider Name | Leon Siu Tio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952741795 PECOS PAC ID: 1759677271 Enrollment ID: I20160909001480 |
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