MERCY FAMILY CLINIC NPI 1154560027

NPI Information

NPI: 1154560027
Provider Name: MERCY FAMILY CLINIC

Former Legal Business Name: EBERE ISRAEL AZUBUIKE MD PA

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2015669

Address:
2409 ALCO AVE
DALLAS, TX
ZIP 75211
Phone: (214) 942-2377
Get Directions

MERCY FAMILY CLINIC is a family medicine in Dallas, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MERCY FAMILY CLINIC NPI is 1154560027. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Ebere Israel Azubuike Md Pa.

The provider's business location address is:

2409 ALCO AVE
DALLAS, TX
ZIP 75211-614
Phone: (214) 942-2377
Fax: (214) 942-2977

The provider's authorized official is Ebere Israel Azubuike .
The authorized official title is President/ Ceo and has the following contact phone number (214) 942-2377.

The CLIA number assigned to this NPI record is 45D2015669 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2009 and was last updated on 6/2/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		M9136	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	M9136	OTHER	TEXAS	LICENCE
2	8F21538	MEDICARE PIN	TEXAS
3	0069SD	OTHER	TEXAS	BCBS OF TX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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