| Dallas 365, Pllc | |
|
5521 Bellaire Dr S Ste 200 Ft Worth TX 76109-5855 | |
| (817) 670-5812 | |
| (817) 549-3856 |
| Full Name | Dallas 365, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5521 Bellaire Dr S Ste 200, Ft Worth, Texas |
| Authorized Official Name and Position | Jeffery Fritz (OWNER) |
| Authorized Official Contact | 5124220633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas 365, Pllc 13101 Preston Rd # 110648 Dallas TX 75240-5237 Ph: (512) 422-0633 | Dallas 365, Pllc 5521 Bellaire Dr S Ste 200 Ft Worth TX 76109-5855 Ph: (817) 670-5812 |
| NPI Number | 1932660636 |
|---|---|
| Provider Enumeration Date | 03/26/2019 |
| Last Update Date | 10/03/2024 |
| Medicare PECOS PAC ID | 7517343833 |
|---|---|
| Medicare Enrollment ID | O20221010002057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932660636 | NPI | - | NPPES |
| Provider Name | Michelle Ann Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083710685 PECOS PAC ID: 2668555772 Enrollment ID: I20080213000308 |
| Provider Name | Jeffery M Fritz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861562407 PECOS PAC ID: 5395811517 Enrollment ID: I20080911000346 |
| Provider Name | Michael S Elrod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356939334 PECOS PAC ID: 9739585233 Enrollment ID: I20210909000033 |
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