Individual ProviderAutumn SavageFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1300 W Rosedale St Ste A, Fort Worth, TX 76104-2824(817) 730-5300(513) 252-7792PECOS EnrollmentBased on the most recent information from CMS, provider Autumn Savage is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1245598408Provider TypeIndividualFull NameSavage, AutumnCredentialD.O.GenderFemaleSole ProprietorYesEnumeration Date4/25/2012Last Updated9/21/2020Contact InformationPractice LocationPractice Address1300 W Rosedale St Ste A, Fort Worth, TX 76104-2824Phone(817) 730-5300Fax(817) 989-6819Mailing LocationMailing AddressPO Box 3409, Pflugerville, TX 78691-3409Phone(513) 252-7792Fax(513) 904-5908Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseQ2848TexasProvider IdentifiersIDDescriptionIssuerID366545702DescriptionMedicaidIssuerUnlistedTexasID366545703DescriptionMedicaidIssuerUnlistedTexasID366545701DescriptionMedicaidIssuerUnlistedTexas