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SPARKS CLINIC PA NPI 1841214467


NPI Information

NPI: 1841214467
Provider Name: SPARKS CLINIC PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D0477913

Address:
103 N 1ST STREET
ROCKWALL, TX
ZIP 75087
Phone: (972) 771-5366
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SPARKS CLINIC PA is a family medicine in Rockwall, 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. SPARKS CLINIC PA NPI is 1841214467. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

103 N 1ST STREET
ROCKWALL, TX
ZIP 75087-033
Phone: (972) 771-5366
Fax: (972) 771-0424

The provider's authorized official is Robert Dale Sparks .
The authorized official title is Owner and has the following contact phone number (972) 771-5366.

The CLIA number assigned to this NPI record is 45D0477913 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 7/28/2008.


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
1207Q00000XFamily MedicineF0682TEXASYes

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
100CJ95MEDICARE PINTEXAS
21841214467MEDICARE OSCAR/CERTIFICATION

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: 5/5/2024

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