| Medical Associates At Willow Park | |
|
260 Willow Bend Dr Aledo TX 76008-1188 | |
| (817) 441-9252 | |
| (817) 441-9282 |
| Full Name | Medical Associates At Willow Park |
|---|---|
| Speciality | Family Medicine |
| Location | 260 Willow Bend Dr, Aledo, Texas |
| Authorized Official Name and Position | Matthew Gorman Stine (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8174419252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Associates At Willow Park 260 Willow Bend Dr Aledo TX 76008-1188 Ph: (817) 441-9252 | Medical Associates At Willow Park 260 Willow Bend Dr Aledo TX 76008-1188 Ph: (817) 441-9252 |
| NPI Number | 1821460239 |
|---|---|
| Provider Enumeration Date | 10/25/2015 |
| Last Update Date | 10/25/2015 |
| Medicare PECOS PAC ID | 6305143298 |
|---|---|
| Medicare Enrollment ID | O20160321000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821460239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M9034 (Texas) | Primary |
| Provider Name | Matthew G Stine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871770164 PECOS PAC ID: 1951454321 Enrollment ID: I20090803000170 |
| Provider Name | Chelsea Townsend Fogle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194236216 PECOS PAC ID: 7012263015 Enrollment ID: I20180705001523 |
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