| Livingspring Family Medical Center Pllc | |
|
3807 E Broad St Ste 101 Mansfield TX 76063-5623 | |
| (817) 717-9597 | |
| (833) 992-1938 |
| Full Name | Livingspring Family Medical Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3807 E Broad St Ste 101, Mansfield, Texas |
| Authorized Official Name and Position | Tolulope Olabintan (OWNER) |
| Authorized Official Contact | 2676407762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingspring Family Medical Center Pllc 3807 E Broad St Ste 101 Mansfield TX 76063-5623 Ph: (817) 717-9597 | Livingspring Family Medical Center Pllc 3807 E Broad St Ste 101 Mansfield TX 76063-5623 Ph: (817) 717-9597 |
| NPI Number | 1043813603 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 10/18/2021 |
| Medicare PECOS PAC ID | 4688087224 |
|---|---|
| Medicare Enrollment ID | O20201229000407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043813603 | NPI | - | NPPES |
| 184418001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Tolulope Mary Olabintan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558686105 PECOS PAC ID: 6103018833 Enrollment ID: I20191023001441 |
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