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NPI Code Detail

MEDICARE: ALFORD WADE

MEDICARE:   ALFORD  WADE
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
1101YP2500XProfessional Counselor70450TX

General Provider Information

NPI Number : 1093240780
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALFORD WADE
Provider Business Mailing Address
First Line : 8217 CEDARCREST LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-4631
Country : US
Telephone Number : 817-845-9663
Fax Number :
Provider Business Practice Location Address
First Line : 4701 ALTAMESA BLVD STE 1F
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-6135
Country : US
Telephone Number : 817-370-1223
Fax Number : 817-370-1225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2017
Last Update Date : 02/04/2026

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Directions to “ ALFORD WADE ” Practice Location

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