| Foundation Family Practice Pllc | |
|
3120 Capital Way Unit 602 Fort Worth TX 76177-4305 | |
| (714) 704-3345 | |
| (714) 704-3463 |
| Full Name | Foundation Family Practice Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3120 Capital Way Unit 602, Fort Worth, Texas |
| Authorized Official Name and Position | Oladotun Olushola Akinmurele (CEO) |
| Authorized Official Contact | 8177043345 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundation Family Practice Pllc 3120 Capital Way Unit 602 Fort Worth TX 76177-4305 Ph: (817) 704-3345 | Foundation Family Practice Pllc 3120 Capital Way Unit 602 Fort Worth TX 76177-4305 Ph: (714) 704-3345 |
| NPI Number | 1699516914 |
|---|---|
| Provider Enumeration Date | 06/03/2024 |
| Last Update Date | 12/06/2024 |
| Medicare PECOS PAC ID | 8426584376 |
|---|---|
| Medicare Enrollment ID | O20241216001676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699516914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Oladotun Akinmurele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013221969 PECOS PAC ID: 9638349632 Enrollment ID: I20241216001855 |
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