FORT WORTH LUNG CLINIC, PA – Primary Care Clinic/Center, NPI 1558655274
Primary Care Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for FORT WORTH LUNG CLINIC, PA
800 8th Ave Ste 412
Fort Worth, TX 761042618
Phone: (817) 336-8773
Fax: (817) 338-1063
Type: Location
8036 OCEAN DR
FORT WORTH, TX 761231895
Phone: (817) 739-1080
Fax: (817) 370-7942
Type: Location
11803 SOUTH FWY STE 136
BURLESON, TX 760288460
Phone: (817) 568-8411
Fax: (817) 568-8414
Type: Location
PO BOX 16284
FORT WORTH, TX 761620284
Phone: (817) 739-1080
Fax: (817) 370-7942
Type: Mailing
11803 SOUTH FWY STE 311
BURLESON, TX 760287036
Phone: (817) 568-8411
Fax: (817) 568-8414
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-09-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-10-31 (223 days ago).
Enrollment records
1
Earliest due date
2025-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20110923000606 | O | Clinic/Group Practice | TX | 2025-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76104)
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