Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Ativa Health Center LLC

Organization Family Medicine Physician · NPI 1659688406

Ativa Health Center LLC provides Family Medicine Physician services in Fort Worth, Texas. Registered with an NPI since 2010.

In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3510 E Lancaster Ave Ste B
Fort Worth, TX 76103-2555 Not confirmed with CMS for 16 years — call before visiting
Phone: (817) 536-0219
Fax: (817) 536-0311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1659688406
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yulia Polikhova — Owner · (817) 536-0219
NPI enumeratedAugust 31, 2010
Last updated in NPPESAugust 31, 2010
Mailing address3510 E Lancaster Ave, Suite B, Fort Worth, TX 76103-2555

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