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MALCOLM X PEDIATRIC CLINIC NPI 1518290469


NPI Information

NPI: 1518290469
Provider Name: MALCOLM X PEDIATRIC CLINIC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization

CLIA Number: 45D1000844

Address:
4432 MALCOLM X BLVD
DALLAS, TX
ZIP 75215
Phone: (214) 428-2010
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MALCOLM X PEDIATRIC CLINIC is a nurse practitioner in Dallas, TX. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. MALCOLM X PEDIATRIC CLINIC NPI is 1518290469. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4432 MALCOLM X BLVD
DALLAS, TX
ZIP 75215-349
Phone: (214) 428-2010
Fax: (214) 428-2065

The provider's authorized official is Ruth Greer .
The authorized official title is Owner and has the following contact phone number (214) 428-2010.

The CLIA number assigned to this NPI record is 45D1000844 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/10/2009 and was last updated on 9/10/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily245458TEXASNo
2363LP0200XNurse PractitionerPediatrics245458TEXASNo
3363L00000XNurse Practitioner245458TEXASYes

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

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