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BESTAWROUS FAMILY CLINIC NPI 1265600308


NPI Information

NPI: 1265600308
Provider Name: BESTAWROUS FAMILY CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D1059658

Address:
1200 KELLER PKWY
100
KELLER, TX
ZIP 76248
Phone: (817) 741-8011
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BESTAWROUS FAMILY CLINIC is a family medicine in Keller, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BESTAWROUS FAMILY CLINIC NPI is 1265600308. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 KELLER PKWY
100
KELLER, TX
ZIP 76248
Phone: (817) 741-8011
Fax: (817) 741-8005

The provider's authorized official is Reda S Bestawrous .
The authorized official title is Owner Physician and has the following contact phone number (817) 741-8011.

The CLIA number assigned to this NPI record is 45D1059658 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/12/2008 and was last updated on 12/24/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineK3989TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18X1830OTHERTEXASBCBS
20A0056MEDICARE PINTEXAS
3G60895MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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