Organization
FELIZ FAMILY MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEEMA MOTTACKAL GEORGE FNP (OWNER)
(972) 965-9402
Entity
Organization
Contact information
Practice address
3109 6TH AVE, FORT WORTH, TX 76110-3800
(817) 923-7055
(817) 923-7902
Mailing address
200 DEER CREEK LN, SUNNYVALE, TX 75182-3204
(972) 965-9402
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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