Healthcare Provider Details

I. General information

NPI: 1386849883
Provider Name (Legal Business Name): BFC HEALTHCARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W GIBSON ST
JASPER TX
75951-4936
US

IV. Provider business mailing address

150 W GIBSON ST
JASPER TX
75951-4936
US

V. Phone/Fax

Practice location:
  • Phone: 409-384-7776
  • Fax: 409-384-7779
Mailing address:
  • Phone: 409-384-7776
  • Fax: 409-384-7779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number6063
License Number StateTX

VIII. Authorized Official

Name: DR. MICHAEL TODD FLECK
Title or Position: PRESIDENT
Credential: D.C.
Phone: 409-384-7776