MEDICARE: NOAAK HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	AP132859	TX

General Provider Information

NPI Number	:	1578040580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOAAK HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 788
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-0788
Country	:	US
Telephone Number	:	817-382-0005
Fax Number	:	682-334-7238

Provider Business Practice Location Address
First Line	:	648 E BUTLER ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-5523
Country	:	US
Telephone Number	:	817-382-0005
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE KHEN ZAMA MBUH
Credential	:	NP
Telephone Number	:	443-694-3931

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	05/08/2026

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Directions to “NOAAK HEALTHCARE LLC ” Practice Location

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