MEDICARE: ARLINGTON MINOR EMERGENCY CLINIC, 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	207Q00000X	Family Medicine Physician

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	:	1528299625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON MINOR EMERGENCY CLINIC, PA

Provider Business Mailing Address
First Line	:	PO BOX 301085
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76007-1085
Country	:	US
Telephone Number	:	814-277-2977
Fax Number	:	817-277-4750

Provider Business Practice Location Address
First Line	:	912 E PARK ROW DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-4507
Country	:	US
Telephone Number	:	817-277-2977
Fax Number	:	817-277-4750

Authorized Official
Title or Position	:	DOCTOR
Name	:	THAO QUI NGUYEN
Credential	:	D.O.
Telephone Number	:	817-277-2977

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	01/08/2013

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