MEDICARE: DYNAMIC RPA HEALTHCARE PA

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1336681170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC RPA HEALTHCARE PA

Provider Business Mailing Address
First Line	:	3750 S UNIVERSITY DR STE 275
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3795
Country	:	US
Telephone Number	:	817-294-9600
Fax Number	:	817-294-9611

Provider Business Practice Location Address
First Line	:	3750 S UNIVERSITY DR STE 275
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3795
Country	:	US
Telephone Number	:	817-294-9600
Fax Number	:	817-294-9611

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER A INEAMA
Credential	:	PA
Telephone Number	:	817-294-9600

Provider Enumeration Date	:	11/10/2016
Last Update Date	:	07/21/2022

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Directions to “DYNAMIC RPA HEALTHCARE PA ” Practice Location

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