MEDICARE: WESTERN CLINICAL HEALTH SERVICES, 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
1	251B00000X	Case Management Agency	0000082	TX

General Provider Information

NPI Number	:	1568472850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN CLINICAL HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	700 HEMPHILL ST
Second Line	:	SUITE A
City	:	FT WORTH
State	:	TX
Zip	:	76104-3105
Country	:	US
Telephone Number	:	817-334-0111
Fax Number	:	817-334-0249

Provider Business Practice Location Address
First Line	:	700 HEMPHILL ST
Second Line	:	SUITE A
City	:	FT WORTH
State	:	TX
Zip	:	76104-3105
Country	:	US
Telephone Number	:	817-334-0111
Fax Number	:	817-334-0249

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. LUIS ARCE
Credential	:	MD
Telephone Number	:	817-334-0111

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/22/2020

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