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NPI Code Detail

MEDICARE: DR. DOUGLAS SEGARS D.O.

MEDICARE:  DR. DOUGLAS  SEGARS  D.O.
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0800XPsychiatry PhysicianP2361TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18DK393OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649553165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS SEGARS D.O.
Provider Business Mailing Address
First Line : 3840 HULEN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-7277
Country : US
Telephone Number : 817-569-4300
Fax Number :
Provider Business Practice Location Address
First Line : 2400 NW 24TH ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76106-6629
Country : US
Telephone Number : 817-569-5000
Fax Number : 817-569-5048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 01/03/2020

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Directions to “ DR. DOUGLAS SEGARS D.O.” Practice Location

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