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NPI 1538950837

NPI 1538950837 : CAMP BERF ACQUISITION PARTNERS LLC : FORT WORTH, TX

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General NPI Number Information
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    NPI Number           |    1538950837
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    Entity Type          |    Organization 
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    Legal Business Name  |    CAMP BERF ACQUISITION PARTNERS LLC 
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Dates
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    Enumeration Date     |    05/15/2025
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    Last Update Date     |    05/15/2025
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Provider Practice Location Address
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    Address Line         |    6006 CAMP BOWIE BLVD 
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    City                 |    FORT WORTH
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    State                |    TX
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    Zip                  |    76116-5620
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    Country              |    US
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    Telephone            |    817-439-4912
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 92385 
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    City                 |    SOUTHLAKE
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    State                |    TX
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    Zip                  |    76092-0104
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    COO
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    Name                 |     JULIE  RADLEY 
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    Credential           |    
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    Telephone            |    713-591-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QE0002X
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    Taxonomy Name        |    Emergency Care Clinic/Center
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    License Number       |    
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    License Number State |    
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