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NPI Code Detail

MEDICARE: CATHOLIC CHARITIES DIOCESE OF FORT WORTH INC

MEDICARE: CATHOLIC CHARITIES DIOCESE OF FORT WORTH 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
1171W00000XContractor

Other Identifiers

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

General Provider Information

NPI Number : 1386807204
Entity Type Code : Organization
Provider Name (Legal Business Name) : CATHOLIC CHARITIES DIOCESE OF FORT WORTH INC
Provider Business Mailing Address
First Line : 2701 BURCHILL RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-3012
Country : US
Telephone Number : 817-413-3912
Fax Number : 817-535-8779
Provider Business Practice Location Address
First Line : 2701 BURCHILL RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-3012
Country : US
Telephone Number : 817-413-3912
Fax Number : 817-535-8779
Authorized Official
Title or Position : VICE PRESIDENT OF ADMINISTRATION
Name : MRS. MONICA GAIL QUIROZ
Credential :
Telephone Number : 817-413-3912
Provider Enumeration Date : 07/10/2008
Last Update Date : 07/10/2008

Similar Medicare Providers

1962445791 — CATHOLIC CHARITIES OF FORT WORTH, INC
Practice Location Address:
2701 BURCHILL RD N
FORT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax: 817-536-1556
1205941598 — MARY ELOUISE GRAVES LMFT
Practice Location Address:
2701 BURCHILL RD N
FORT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax: 817-536-1556
1679680094 — MR. RUSSELL MARTIN DEAN LPC
Practice Location Address:
2701 BURCHILL RD N
FT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax: 817-536-1556
1104938968 — MRS. MERRY LOUISE FLOYD LCSW
Practice Location Address:
2701 BURCHILL RD N
FORT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax: 817-536-1556
1578799649 — JENNIFER LEE SHEFFIELD R.N.
Practice Location Address:
2701 BURCHILL RD N
FORT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax:
1447482641 — CHARLES HENRY LAVINE LPC-S
Practice Location Address:
2701 BURCHILL RD N
FORT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax: 817-536-1556

Directions to “CATHOLIC CHARITIES DIOCESE OF FORT WORTH INC ” Practice Location

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