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NPI Code Detail

MEDICARE: TEXAS CARE CENTER FW NW LLC

MEDICARE: TEXAS CARE CENTER FW NW LLC
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
1101YP2500XProfessional Counselor
2251B00000XCase Management Agency

General Provider Information

NPI Number : 1598617912
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS CARE CENTER FW NW LLC
Provider Business Mailing Address
First Line : 4200 SOUTH FWY STE 2530
Second Line :
City : FORT WORTH
State : TX
Zip : 76115-1400
Country : US
Telephone Number : 469-918-3430
Fax Number :
Provider Business Practice Location Address
First Line : 4200 SOUTH FWY STE 2530
Second Line :
City : FORT WORTH
State : TX
Zip : 76115-1400
Country : US
Telephone Number : 469-918-3430
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JERRY MOORE
Credential :
Telephone Number : 469-918-3430
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “TEXAS CARE CENTER FW NW LLC ” Practice Location

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