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PATRICIA B NEWCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD RN CPNP

Contact information

Practice address
2528 JACKSBORO HWY, FORT WORTH, TX 76114-2206
(817) 625-1770
(817) 625-1287
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
510094
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00U87Z
MEDICARE GROUP PIN
TX
05
062615204
TX
01
062615205
CSHCN INDIVIDUAL TPI
TX
01
137345810
CSHCN GROUP TPI
TX
01
140442852
MEDICAID GROUP TPI
TX
01
1750369203
NPI GROUP NUMBER
TX
Enumeration date
06/18/2005
Last updated
05/20/2010
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