Organization
ANGEL'S STAR WELLNESS CENTER, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK NGUYEN (MANAGEMENT)
(817) 791-1811
Entity
Organization
Contact information
Practice address
8325 WHITLEY RD, SUITE: 100, WATAUGA, TX 76148-2487
(817) 479-1181
(817) 918-4432
Mailing address
8325 WHITLEY RD, SUITE: 100, WATAUGA, TX 76148-2487
(817) 479-1181
(817) 750-2789
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L0508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072PD
BCBS
TX
05
—
191341001
—
TX
01
—
DH2407
MEDICARE RAILROAD
—
Enumeration date
12/12/2006
Last updated
10/20/2021
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