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NPI Code Detail

MEDICARE: GOSHEN FAMILY CLINIC, INC.

MEDICARE: GOSHEN FAMILY CLINIC, INC.
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1821594045
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOSHEN FAMILY CLINIC, INC.
Provider Business Mailing Address
First Line : 6080 S HULEN ST STE 360
Second Line : PMB 198
City : FORT WORTH
State : TX
Zip : 76132-4810
Country : US
Telephone Number : 817-492-1700
Fax Number :
Provider Business Practice Location Address
First Line : 6801 MCCART AVE STE 109
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-6378
Country : US
Telephone Number : 817-492-1700
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : RHODA STEVENS
Credential : FNP-BC
Telephone Number : 817-492-1700
Provider Enumeration Date : 04/05/2018
Last Update Date : 10/07/2023

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Directions to “GOSHEN FAMILY CLINIC, INC. ” Practice Location

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