Organization
EMCC AZLE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE NEWSOM (VP OF OPERATIONS)
(817) 271-2583
Entity
Organization
Contact information
Practice address
601 NORTHWEST PKWY STE C, AZLE, TX 76020-2930
(817) 270-0788
Mailing address
2300 MATLOCK RD STE 35, MANSFIELD, TX 76063-5018
(469) 830-8200
(469) 830-8201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/12/2019
Last updated
05/18/2023
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