Individual
JADWIGA A KLYMIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-4151
(817) 702-4161
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-8450
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L5416
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158291803
—
TX
01
—
8U1298
BCBS
TX
01
—
P00275252
RAILROAD MEDICARE
TX
Enumeration date
05/18/2006
Last updated
11/07/2018
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