Organization
ELITE HEALTHCARE OF MANSFIELD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH JENSEN D.C. (PRESIDENT)
(817) 453-5001
Entity
Organization
Contact information
Practice address
1600 HIGHWAY 287 N, SUITE 104, MANSFIELD, TX 76063-8853
(817) 453-5001
Mailing address
1600 HIGHWAY 287 N, SUITE 104, MANSFIELD, TX 76063-8853
(817) 453-5001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040EG
BLUE CROSS BLUE SHIELD TX
TX
Enumeration date
11/13/2006
Last updated
06/16/2008
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