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NPI Code Detail

MEDICARE: NANCY J HITZFELDER MD

MEDICARE: NANCY J HITZFELDER MD
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
12080P0008XPediatric Neurodevelopmental Disabilities PhysicianE6098TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31548230923OTHERTXGROUP NPI NUMBER

General Provider Information

NPI Number : 1669495792
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY J HITZFELDER MD
Provider Business Mailing Address
First Line : 1300 W LANCASTER
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3484
Country : US
Telephone Number : 817-336-2823
Fax Number : 682-885-7347
Provider Business Practice Location Address
First Line : 1300 W LANCASTER AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3410
Country : US
Telephone Number : 817-336-8611
Fax Number : 682-336-2823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 04/29/2010

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