Organization
ICARE COMMUNITY SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TUAN NGOC PHAM (OWNER)
(817) 933-2411
Entity
Organization
Contact information
Practice address
5813 OAKMONT LN, FORT WORTH, TX 76112-2003
(817) 933-2411
Mailing address
5813 OAKMONT LN, FORT WORTH, TX 76112-2003
(817) 933-2411
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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