# REMEDIOS R. CABANSAG , MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104157106
- **Authorized official:** DR. REMEDIOS R. CABANSAG MD (PRESIDENT,VICE PRESIDENT,SEC/TREAS)
- **Authorized official phone:** (817) 551-2963

## Contact information

- **Practice address:** 11803 SO. FREEWAY, SUITE 254, FORT WORTH, TX 76115-0337
- **Practice address phone:** (817) 551-2963
- **Practice address fax:** (817) 568-1663
- **Mailing address:** 11803 SO. FREEWAY, SUITE 254, FORT WORTH, TX 76115-0337
- **Mailing address phone:** (817) 551-2963
- **Mailing address fax:** (817) 568-1663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | D9958 | TX | Yes |

## Other

- **Enumeration date:** 01/15/2010
- **Last updated:** 01/15/2010