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Individual

A CLIFTON CAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 735-2228
(817) 735-2582
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2228
(817) 735-2582

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J5719
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080087204
RAILROAD MEDICARE PIN
TX
05
117541603
TX
01
847567
BCBS
TX
Enumeration date
03/15/2006
Last updated
10/09/2008
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