Healthcare Provider Details

I. General information

NPI: 1720413644
Provider Name (Legal Business Name): PRONTO CARE MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 MCCART AVE STE A1
FT WORTH TX
76133-6368
US

IV. Provider business mailing address

6801 MCCART AVE STE A1
FT WORTH TX
76133-6368
US

V. Phone/Fax

Practice location:
  • Phone: 817-292-0300
  • Fax: 817-292-0328
Mailing address:
  • Phone: 817-292-0300
  • Fax: 817-292-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSIE HICKS
Title or Position: PRESIDENT
Credential: DO
Phone: 817-292-0300