MEDICARE: MACLIN FAMILY MEDICINE 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
1	207Q00000X	Family Medicine Physician	L3738	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1124338785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACLIN FAMILY MEDICINE PLLC

Provider Business Mailing Address
First Line	:	6800 MANHATTAN BLVD BLDG 1
Second Line	:	STE 101
City	:	FORT WORTH
State	:	TX
Zip	:	76120-1200
Country	:	US
Telephone Number	:	817-457-7200
Fax Number	:	817-457-7258

Provider Business Practice Location Address
First Line	:	1521 N COOPER ST STE 213
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5522
Country	:	US
Telephone Number	:	877-288-7968
Fax Number	:	754-218-0975

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROWENA MACLIN
Credential	:	D.O.
Telephone Number	:	877-288-7968

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	07/14/2022

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