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NPI Code Detail

MEDICARE: LIVINGSPRING FAMILY MEDICAL CENTER PLLC

MEDICARE: LIVINGSPRING FAMILY MEDICAL CENTER PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043813603
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVINGSPRING FAMILY MEDICAL CENTER PLLC
Provider Business Mailing Address
First Line : 3807 E BROAD ST STE 101
Second Line : 101
City : MANSFIELD
State : TX
Zip : 76063-5623
Country : US
Telephone Number : 817-717-9597
Fax Number : 833-992-1938
Provider Business Practice Location Address
First Line : 3807 E BROAD ST STE 101
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5623
Country : US
Telephone Number : 817-717-9597
Fax Number : 833-992-1938
Authorized Official
Title or Position : MD
Name : TOLULOPE MARY OLABINTAN
Credential : MD
Telephone Number : 817-717-9597
Provider Enumeration Date : 11/17/2020
Last Update Date : 06/29/2026

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Directions to “LIVINGSPRING FAMILY MEDICAL CENTER PLLC ” Practice Location

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