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NPI Code Detail

MEDICARE: FOREFRONT TELECARE INC

MEDICARE: FOREFRONT TELECARE INC
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
12084P0800XPsychiatry 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
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174035612
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOREFRONT TELECARE INC
Provider Business Mailing Address
First Line : 1717 MAIN ST STE 5850
Second Line :
City : DALLAS
State : TX
Zip : 75201-7317
Country : US
Telephone Number : 972-449-0540
Fax Number :
Provider Business Practice Location Address
First Line : 1717 MAIN ST STE 5850
Second Line :
City : DALLAS
State : TX
Zip : 75201-7317
Country : US
Telephone Number : 972-449-0540
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF PAYER OPERATION
Name : SARA VITULLO
Credential :
Telephone Number : 815-735-8600
Provider Enumeration Date : 10/24/2017
Last Update Date : 02/04/2026

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Directions to “FOREFRONT TELECARE INC ” Practice Location

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