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ST MARYS FAMILY CLINIC PLLC NPI 1619697877


NPI Information

NPI: 1619697877
Provider Name: ST MARYS FAMILY CLINIC PLLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 45D2276611

Address:
3730 N JOSEY LN STE 120
CARROLLTON, TX
ZIP 75007
Phone: (972) 999-3593
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ST MARYS FAMILY CLINIC PLLC is a clinic center in Carrollton, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ST MARYS FAMILY CLINIC PLLC NPI is 1619697877. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3730 N JOSEY LN STE 120
CARROLLTON, TX
ZIP 75007-439
Phone: (972) 999-3593

The provider's authorized official is Remi Thomas .
The authorized official title is Owner and has the following contact phone number (972) 999-3593.

The CLIA number assigned to this NPI record is 45D2276611 - other - family medical clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2022 and was last updated on 9/7/2022.


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
1363LF0000XNurse PractitionerFamilyNo
2261Q00000XClinic/CenterYes

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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