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NPI Code Detail

MEDICARE: 1ST CHOICE MEDICAL GROUP PLLC

MEDICARE: 1ST CHOICE MEDICAL GROUP PLLC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1700164662
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ST CHOICE MEDICAL GROUP PLLC
Provider Business Mailing Address
First Line : PO BOX 151186
Second Line :
City : FORT WORTH
State : TX
Zip : 76108-5186
Country : US
Telephone Number : 817-263-9700
Fax Number : 817-263-9706
Provider Business Practice Location Address
First Line : 903 SUMMIT AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3421
Country : US
Telephone Number : 817-877-5353
Fax Number : 817-877-5357
Authorized Official
Title or Position : PRESIDENT
Name : JASON MEYER
Credential : DC
Telephone Number : 817-456-2555
Provider Enumeration Date : 07/26/2011
Last Update Date : 07/26/2011

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Directions to “1ST CHOICE MEDICAL GROUP PLLC ” Practice Location

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