Organization
EMCC PANTEGO PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE NEWSOM (PRESIDENT)
(469) 830-8200
Entity
Organization
Contact information
Practice address
1607 S BOWEN RD, PANTEGO, TX 76013-3337
(817) 421-0034
(817) 421-0036
Mailing address
2300 MATLOCK RD STE 35, MANSFIELD, TX 76063-5018
(469) 830-8200
(469) 830-8201
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
11/16/2018
Last updated
09/27/2024
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