MEDICARE: ARLINGTON PREVENTIVE CARE MEDICAL CLINIC P A

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	207R00000X	Internal Medicine Physician	J8147	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	:	1245419647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON PREVENTIVE CARE MEDICAL CLINIC P A

Provider Business Mailing Address
First Line	:	1800 W PIONEER PKWY
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6105
Country	:	US
Telephone Number	:	817-274-0329
Fax Number	:	817-274-0127

Provider Business Practice Location Address
First Line	:	1800 W PIONEER PKWY
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6105
Country	:	US
Telephone Number	:	817-274-0329
Fax Number	:	817-859-8139

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JEANINE HOLMES-THOMAS
Credential	:	D.O.
Telephone Number	:	817-274-0329

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	02/11/2025

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