Provider Demographics
NPI:1093885154
Name:CITYVIEW FAMILY PHYSICIANS
Entity Type:Organization
Organization Name:CITYVIEW FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER, CPC
Authorized Official - Prefix:MISS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWOR
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:817-263-9412
Mailing Address - Street 1:5701 BRYANT IRVIN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4029
Mailing Address - Country:US
Mailing Address - Phone:817-263-9412
Mailing Address - Fax:817-346-4006
Practice Address - Street 1:5701 BRYANT IRVIN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4029
Practice Address - Country:US
Practice Address - Phone:817-263-9412
Practice Address - Fax:817-346-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00726TMedicare PIN