H PENA MD NORTH MAIN MEDICAL AND SURGICAL CLINIC ASSOC (NPI# 1477607240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477607240 |
| Entity Type | Organization |
| Organization Name | H PENA MD NORTH MAIN MEDICAL AND SURGICAL CLINIC ASSOC |
| Practice Address |
3301 North Main Street Fort Worth TX 76106 |
| Practice Telephone | 8176252791 |
| Practice Fax Number | 8177401550 |
| Mailing Telephone | 8176252791 |
| Mailing Fax Number | 8177401550 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HERIBERTO PENA (PRESIDENT) |
| Authorized Official Telephone | 8176252791 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | C7083 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
3301 NORTH MAIN STREET |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215380985 | Irene Robyn Winnett | Counselor | 2907 Loving Ave, Fort Worth, TX 76106 | 2016-07-19 |
| 1568875706 | Valerie Freeman Biegon | Contractor | A La Mod Salon/ Vfb-lmt, 3900 Merrett Drive Suite B, Lake Worth, TX 76106 | 2014-06-05 |
| 1659555738 | Northside Adult Daycare Center, Inc. | Clinic/Center | 1401 Clinton Ave, Fort Worth, TX 76106 | 2007-12-24 |
| 1285755504 | Nortside Medical Clinic, P.a. | Family Medicine | 1600 25th Street, Suite B, Fort Worth, TX 76106 | 2007-04-03 |
| 1093800153 | Jinat Corporation | Dentist | 1612 Nw 28th St, Fort Worth, TX 76106 | 2006-10-04 |
| 1568751006 | Elizabeth Rivera | Family Medicine | 3308 Deen Rd, Fort Worth, TX 76106 | 2011-04-05 |
| 1104156173 | Katherine Courtney Thompson | Speech-Language Pathologist | 3600 Angle Ave, Fort Worth, TX 76106 | 2010-01-13 |
| 1417066507 | Priyanka Kandhari | Dentist | 3308 Deen Rd, Fort Worth, TX 76106 | 2006-08-30 |
| 1417518648 | Kristina Lahti | Occupational Therapist | 4775 North Fwy, Fort Worth, TX 76106-2315 | 2019-06-27 |
| 1538773072 | Michael David Castillon | Behavior Technician | 4775 North Fwy, Fort Worth, TX 76106-2315 | 2020-09-02 |
| Find all providers in zip 76106 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174147912 | Earnest A Porter | General Practice | 6324 Glenwick Dr, Fort Worth, TX 76123-1565 | 2020-06-07 |
| 1386200889 | Wholelife Authentic Care Provider Network | General Practice | 1000 Bonnie Brae Ave Ste 120, Fort Worth, TX 76111-4301 | 2019-05-10 |
| 1336681170 | Dynamic Rpa Healthcare Pa | General Practice | 3750 S University Dr Ste 275, Fort Worth, TX 76109-3795 | 2016-11-10 |
| 1588906218 | Susan Moses Shropshire | General Practice | 4812 Camp Bowie Blvd, Suite B, Fort Worth, TX 76107-4121 | 2013-03-20 |
| 1376817932 | Gordon Patterson Sharratt | General Practice | 3605 Roberts Cut Off Rd, Fort Worth, TX 76114-1039 | 2012-02-29 |
| 1063785665 | Linda Atlas Reese | General Practice | 1001 N Rhea Dr, Fort Worth, TX 76108-3565 | 2012-02-14 |
| 1962711036 | Larry Edwin Bradley | General Practice | 7016 Riverport Rd, Fort Worth, TX 76116-9311 | 2010-10-06 |
| 1922210996 | Paul Lyndon Patrick | General Practice | 14805 Trinity Blvd, Fort Worth, TX 76155-2609 | 2007-05-04 |
| 1518030071 | Barbara Anne Fannin | General Practice | 4101 Marys Creek Dr, Fort Worth, TX 76116 | 2006-11-15 |
| 1083799209 | Chironet, L.L.C. | General Practice | 3149 Lackland Rd, #104, Fort Worth, TX 76116-4109 | 2006-10-26 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76106 |
Please comment or provide details below to improve the information on H PENA MD NORTH MAIN MEDICAL AND SURGICAL CLINIC ASSOC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.