Individual
ERIC ALAN PACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
321 S HENDERSON ST, FORT WORTH, TX 76104-1016
(817) 529-9949
(817) 529-9943
Mailing address
321 S HENDERSON ST, FORT WORTH, TX 76104-1016
(817) 529-9949
(817) 529-9943
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L0479
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018440004
AMERIGROUP
—
05
—
018440004
—
TX
01
—
120897101
PHCS FIRST CARE 12940
—
01
—
139925100
FIRST CARE STAR MEDICAID
—
05
—
152778001
—
TX
01
—
7931102
AETNA
—
01
—
8G6220
BCBS
—
01
—
8G6221
BCBS
TX
01
—
H41514
CIGNA OPTICARE
—
01
—
P00075436
RAILROAD MEDICARE
—
Enumeration date
02/02/2006
Last updated
12/08/2010
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