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FORT WORTH LUNG CLINIC, PA
NPI 1558655274
Clinic/Center - Primary Care in Burleson, TX

Active since May 31, 2011
11803 SOUTH FWY STE 136, BURLESON, TX 76028(817) 568-8411(817) 568-8414 Get Directions Write a Review

NPPES record last updated: February 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 19, 2025, Oct 11, 2021 (2 updates tracked since 2021).

About Fort Worth Lung Clinic, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORT WORTH LUNG CLINIC, PA (NPI 1558655274) is a healthcare organization registered as a primary care in Burleson, Texas and active in the NPI registry since May 2011. The organization maintains a secondary practice location in Fort Worth and lists Dereje Sahel Ayo, President, as its authorized official.

NPPES Registry Identity

NPI1558655274
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameFORT WORTH LUNG CLINIC, PA
Location Address11803 SOUTH FWY STE 136Burleson, TX 76028-8460
Mailing AddressPo Box 16284Fort Worth, TX 76162-0284 · (817) 739-1080 · Fax (817) 370-7942
Phone(817) 568-8411
Fax(817) 568-8414
Organization SubpartNo
Authorized OfficialDereje Sahel AyoPresident · (817) 739-1080
Enumeration DateMay 31, 2011
Last NPPES UpdateFebruary 19, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2025
✔ NPI 1558655274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in TX · N0617
11803 SOUTH FWY STE 136, Burleson, TX 76028
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Secondary Practice Location 1

Location 1800 8th Ave Ste 412Fort Worth, TX 76104-2618 · Phone (817) 336-8773 · Fax (817) 338-1063

Other Identifiers 1

OtherN0617TX · Licence

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fort Worth Lung Clinic, PA's NPI number?

The NPI number for Fort Worth Lung Clinic, PA is 1558655274. It was assigned to this organization in the NPPES registry on May 31, 2011.

Where is Fort Worth Lung Clinic, PA located?

Fort Worth Lung Clinic, PA is located at 11803 South Fwy Ste 136, Burleson, TX 76028. The listed phone number is (817) 568-8411.

What is Fort Worth Lung Clinic, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

What insurance does Fort Worth Lung Clinic, PA accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 2 other insurers list Fort Worth Lung Clinic, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fort Worth Lung Clinic, PA was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.