| Lake Arlington Family Medicine, P.a. | |
|
3901 W Green Oaks Blvd Suite B Arlington TX 76016-2795 | |
| (817) 496-4957 | |
| (817) 496-3783 |
| Full Name | Lake Arlington Family Medicine, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 3901 W Green Oaks Blvd, Arlington, Texas |
| Authorized Official Name and Position | Dennis E Poquiz (PRESIDENT) |
| Authorized Official Contact | 8174964957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Arlington Family Medicine, P.a. 3901 W Green Oaks Blvd Suite B Arlington TX 76016-2795 Ph: (817) 496-4957 | Lake Arlington Family Medicine, P.a. 3901 W Green Oaks Blvd Suite B Arlington TX 76016-2795 Ph: (817) 496-4957 |
| NPI Number | 1053324491 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 01/11/2013 |
| Medicare PECOS PAC ID | 6507019015 |
|---|---|
| Medicare Enrollment ID | O20130114000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053324491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dennis E Poquiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023021458 PECOS PAC ID: 7517058993 Enrollment ID: I20070814000775 |
| Provider Name | Nicole B Jouett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790126738 PECOS PAC ID: 4183867401 Enrollment ID: I20130905000109 |
| Provider Name | Debra C Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699144907 PECOS PAC ID: 5597032763 Enrollment ID: I20170519000609 |
| Provider Name | Kristina Salcedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841790060 PECOS PAC ID: 3870855182 Enrollment ID: I20180327000873 |
| Provider Name | Janelle S Rosenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336779537 PECOS PAC ID: 5193153609 Enrollment ID: I20200317000292 |
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