MEDICARE: FT NETWORK 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
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1649098831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FT NETWORK LLC

Provider Business Mailing Address
First Line	:	2500 WEST FWY STE 200
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-5851
Country	:	US
Telephone Number	:	817-423-4400
Fax Number	:	817-423-8080

Provider Business Practice Location Address
First Line	:	2500 WEST FWY STE 200
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-5851
Country	:	US
Telephone Number	:	817-423-4400
Fax Number	:	817-423-8080

Authorized Official
Title or Position	:	RCM SPECIALIST
Name	:	SHAWNA NIX
Credential	:
Telephone Number	:	817-710-7644

Provider Enumeration Date	:	09/27/2024
Last Update Date	:	09/27/2024

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Directions to “FT NETWORK LLC ” Practice Location

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