MEDICARE: CAREWELL MEDICAL PLLC

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	261QA0600X	Adult Day Care Clinic/Center	719954	TX
2	261QI0500X	Infusion Therapy Clinic/Center	719954	TX
3	261QP2300X	Primary Care Clinic/Center	719954	TX
4	261QU0200X	Urgent Care Clinic/Center	719954	TX

General Provider Information

NPI Number	:	1841536240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREWELL MEDICAL PLLC

Provider Business Mailing Address
First Line	:	4501 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-1004
Country	:	US
Telephone Number	:	817-422-7410
Fax Number	:	817-592-3271

Provider Business Practice Location Address
First Line	:	4501 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-1004
Country	:	US
Telephone Number	:	817-422-7410
Fax Number	:	817-592-3271

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. DANIEL NGOZI EZEUKWU
Credential	:	PHD, FNPBC
Telephone Number	:	817-422-7410

Provider Enumeration Date	:	12/13/2012
Last Update Date	:	12/13/2012

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Directions to “CAREWELL MEDICAL PLLC ” Practice Location

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