Provider Demographics
NPI:1497927883
Name:FM HEALTHCARE, PA
Entity Type:Organization
Organization Name:FM HEALTHCARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BINH
Authorized Official - Middle Name:D
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-457-3853
Mailing Address - Street 1:1127 OAKLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76103-1123
Mailing Address - Country:US
Mailing Address - Phone:817-457-3853
Mailing Address - Fax:817-457-2794
Practice Address - Street 1:1127 OAKLAND BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-1123
Practice Address - Country:US
Practice Address - Phone:817-457-3853
Practice Address - Fax:817-457-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH65478Medicare UPIN