Organization
CENTER FOR FUNCTIONAL MEDICINE AND ULTIMATE WELLNESS
Active
Organization
CENTER FOR FUNCTIONAL MEDICINE AND ULTIMATE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BYRON MCCLAIN SR. MD (MEDICAL DIRECTOR)
(936) 240-0530
Entity
Organization
Contact information
Practice address
615 COMMERCE ST, FORT WORTH, TX 76102-5450
(817) 764-1148
Mailing address
1607 ARROWHEAD DR, PANTEGO, TX 76013-3012
(936) 240-0530
(682) 238-3509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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