| Xpress Provider Service Pllc | |
|
2900 Denton Hwy Ste A Haltom City TX 76117-3763 | |
| (817) 831-2012 | |
| Not Available |
| Full Name | Xpress Provider Service Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 2900 Denton Hwy Ste A, Haltom City, Texas |
| Authorized Official Name and Position | David Teran Chavez (MANAGER) |
| Authorized Official Contact | 8178312012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Xpress Provider Service Pllc 2900 Denton Hwy Ste A Haltom City TX 76117-3763 Ph: (817) 831-2012 | Xpress Provider Service Pllc 2900 Denton Hwy Ste A Haltom City TX 76117-3763 Ph: (817) 831-2012 |
| NPI Number | 1164982039 |
|---|---|
| Provider Enumeration Date | 03/25/2019 |
| Last Update Date | 03/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164982039 | NPI | - | NPPES |
| 308878301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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