MEDICARE: FORT WORTH PROCTOLOGIC CLINIC, PA

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	174400000X	Specialist	E1124	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710217435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT WORTH PROCTOLOGIC CLINIC, PA

Provider Business Mailing Address
First Line	:	1050 W ROSEDALE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4422
Country	:	US
Telephone Number	:	817-338-4501
Fax Number	:	817-338-4503

Provider Business Practice Location Address
First Line	:	1050 W ROSEDALE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4422
Country	:	US
Telephone Number	:	817-338-4501
Fax Number	:	817-338-4503

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SOMMAI SEHAPAYAK
Credential	:	M.D.
Telephone Number	:	817-338-4501

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	12/31/2009

Similar Medicare Providers

1275544330 — SOMMAI SEHAPAYAK MD
Practice Location Address:

1050 W ROSEDALE ST
FORT WORTH, TX
76104-4422

Practice Phone: 817-338-4501
Practice Fax: 817-338-4503

1386194793 — WALGREEN CO
Practice Location Address:

1050 W ROSEDALE ST , STE 100
FORT WORTH, TX
76104-4422

Practice Phone: 682-316-7750
Practice Fax: 682-316-7752

1043025232 — TOLULOPE IBIRONKE AFOLABI
Practice Location Address:

1050 W ROSEDALE ST
FORT WORTH, TX
76104-4422

Practice Phone: 682-361-7750
Practice Fax: 682-361-7752

1619470911 — INGRID AVENT LVN
Practice Location Address:

9820 MARYVILLE LN
FORT WORTH, TX
76108-4422

Practice Phone: 817-500-1946
Practice Fax:

1801766100 — NICOLE CAYLOR LPC ASSOCIATE
Practice Location Address:

3921 BYERS AVE
FORT WORTH, TX
76107-4422

Practice Phone: 817-992-3942
Practice Fax:

1932059482 — KATIE KIRKBRIDE
Practice Location Address:

6433 MALVEY AVE
FORT WORTH, TX
76116-4422

Practice Phone: 805-680-3238
Practice Fax:

Directions to “FORT WORTH PROCTOLOGIC CLINIC, PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.