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General NPI Number Information
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NPI Number | 1083388243
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD HOUSE CALLS PLLC
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 2321 LAUREL FOREST DR
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City | FORT WORTH
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State | TX
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Zip | 76177-3538
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Country | US
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Telephone | 254-231-5793
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Fax |
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Provider Business Mailing Address
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Address Line | 2321 LAUREL FOREST DR
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City | FORT WORTH
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State | TX
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Zip | 76177-3538
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Country | US
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Telephone | 254-231-5793
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TOMMORA JACKSON
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Credential |
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Telephone | 254-231-5793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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