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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