| Jill Gramer DO PA | |
|
6312 Azle Ave Ste 200 Fort Worth TX 76135-2442 | |
| (682) 841-1056 | |
| (682) 841-1161 |
| Full Name | Jill Gramer DO PA |
|---|---|
| Speciality | Family Medicine |
| Location | 6312 Azle Ave Ste 200, Fort Worth, Texas |
| Authorized Official Name and Position | Jill Gramer (PRESIDENT) |
| Authorized Official Contact | 8174419769 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill Gramer DO PA 6312 Azle Ave Ste 200 Fort Worth TX 76135-2442 Ph: (682) 841-1056 | Jill Gramer DO PA 6312 Azle Ave Ste 200 Fort Worth TX 76135-2442 Ph: (682) 841-1056 |
| NPI Number | 1578884029 |
|---|---|
| Provider Enumeration Date | 06/18/2010 |
| Last Update Date | 09/08/2023 |
| Certification Date | 09/08/2023 |
| Medicare PECOS PAC ID | 8426246802 |
|---|---|
| Medicare Enrollment ID | O20101229000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578884029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Mary a Rather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982842217 PECOS PAC ID: 6002962990 Enrollment ID: I20090917000398 |
| Provider Name | Jill a Gramer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447229224 PECOS PAC ID: 6103950696 Enrollment ID: I20100819000575 |
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