MEDICARE: DFW TM MANAGEMENT GROUP 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
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1922485960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DFW TM MANAGEMENT GROUP INC.

Provider Business Mailing Address
First Line	:	2361 S COLLINS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1224
Country	:	US
Telephone Number	:	817-801-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2361 S COLLINS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1224
Country	:	US
Telephone Number	:	817-801-9000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NAM TRAN
Credential	:
Telephone Number	:	817-801-9000

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	04/29/2015

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