MEDICARE: DR. KWAN K OEI MD

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	207Q00000X	Family Medicine Physician	F2828	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	:	1720071434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KWAN K OEI MD

Provider Business Mailing Address
First Line	:	3110 GREENE AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-2318
Country	:	US
Telephone Number	:	817-926-3309
Fax Number	:	817-921-6844

Provider Business Practice Location Address
First Line	:	3110 GREENE AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-2318
Country	:	US
Telephone Number	:	817-926-3309
Fax Number	:	817-921-6844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2005
Last Update Date	:	11/02/2007

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