MEDICARE: WESLEY PARKS

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	101YM0800X	Mental Health Counselor	69918	TX

General Provider Information

NPI Number	:	1205224391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY PARKS

Provider Business Mailing Address
First Line	:	4304 AIRPORT FWY
Second Line	:	SUITE 110
City	:	FORT WORTH
State	:	TX
Zip	:	76117-6218
Country	:	US
Telephone Number	:	817-996-5730
Fax Number	:

Provider Business Practice Location Address
First Line	:	4304 AIRPORT FWY
Second Line	:	SUITE 110
City	:	FORT WORTH
State	:	TX
Zip	:	76117-6218
Country	:	US
Telephone Number	:	817-996-5730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2014
Last Update Date	:	12/30/2014

Similar Medicare Providers

1114098894 — DR. LOUIS PATRICK RICCI DO
Practice Location Address:

16476 EDGEMONT DRIVE
FORT MEYERS, FL
33908-6218

Practice Phone: 239-437-4081
Practice Fax: 239-437-3732

1457353500 — BEENA M. TRIVEDI MD
Practice Location Address:

2919 MARKUM DRIVE
FORT WORTH, TX
76117-4004

Practice Phone: 817-831-0321
Practice Fax: 817-831-3211

1154325132 — SUCHITA REDDY M.D.
Practice Location Address:

2919 MARKUM DR
FORT WORTH, TX
76117

Practice Phone: 817-831-0321
Practice Fax: 817-831-3211

1578514535 — T & R CLINIC A PROFESSIONAL ASSOCIATION
Practice Location Address:

2919 MARKUM DRIVE
FORT WORTH, TX
76117-4004

Practice Phone: 817-831-0321
Practice Fax: 817-831-3211

1700802873 — HALTOM OPERATIONS, LLC
Practice Location Address:

2936 MARKUM DR
FORT WORTH, TX
76117-4001

Practice Phone: 817-831-0545
Practice Fax: 817-831-3051

1568473601 — PAULA M PETERSON FNP
Practice Location Address:

2919 MARKUM DR
FORT WORTH, TX
76117-4004

Practice Phone: 817-831-0321
Practice Fax: 817-831-3211

Directions to “ WESLEY PARKS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.