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General NPI Number Information
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NPI Number | 1114488327
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Entity Type | Organization
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Legal Business Name | A1B HEALTHCARE
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 771 E SOUTHLAKE BLVD
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6341
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Country | US
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Telephone | 817-715-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 5521 MONTHAVEN DR
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City | FORT WORTH
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State | TX
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Zip | 76137-4387
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Country | US
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Telephone | 817-715-6166
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Fax |
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Authorized Official
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Title or Position | FNP/CLINICIAN,OWNER
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Name | PARVANEH ASADI Y
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Credential | NP
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Telephone | 817-715-6166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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