Provider Demographics
NPI:1447774344
Name:BE WELL PRIMARY CARE MEDICINE PLLC
Entity Type:Organization
Organization Name:BE WELL PRIMARY CARE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:682-593-6660
Mailing Address - Street 1:3800 N TARRANT PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5416
Mailing Address - Country:US
Mailing Address - Phone:682-593-6660
Mailing Address - Fax:
Practice Address - Street 1:3800 NORTH TARRANT PARKWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244
Practice Address - Country:US
Practice Address - Phone:682-593-6660
Practice Address - Fax:888-289-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528559325OtherMEDICARE
1396068870OtherMEDICARE
1497019863OtherMEDICARE