# ALLIANCE MEDICAL WEIGHT LOSS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alliance Medical Spa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902150022
- **Authorized official:** DR. MICHAEL L BAILEY D.O. (OWNER)
- **Authorized official phone:** (817) 306-9494

## Contact information

- **Practice address:** 2700 WESTERN CENTER BLVD, SUITE 100, FORT WORTH, TX 76131-4300
- **Practice address phone:** (817) 306-9494
- **Practice address fax:** (817) 306-9093
- **Mailing address:** 2700 WESTERN CENTER BLVD, SUITE 100, FORT WORTH, TX 76131-4300
- **Mailing address phone:** (817) 306-9494
- **Mailing address fax:** (817) 306-9093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | K5446 | UT | Yes |

## Other

- **Enumeration date:** 10/29/2012
- **Last updated:** 10/29/2012