Individual
HEIDI L MEDCALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1500 S MAIN ST, STE 303, FORT WORTH, TX 76104
(817) 921-3431
(817) 927-1605
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 927-1605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183825201
—
TX
Enumeration date
07/17/2006
Last updated
09/23/2009
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