CLINICA MD LLC NPI 1649703430

NPI Information

NPI: 1649703430
Provider Name: CLINICA MD LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 45D2004396

Address:
10325 LAKE JUNE RD STE 330
DALLAS, TX
ZIP 75217
Phone: (214) 928-9800
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CLINICA MD LLC is a family nurse practitioner in Dallas, TX. CLINICA MD LLC NPI is 1649703430. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10325 LAKE JUNE RD STE 330
DALLAS, TX
ZIP 75217-328
Phone: (214) 928-9800
Fax: (972) 232-7441

The provider's authorized official is Lissa Thomas .
The authorized official title is Ceo and has the following contact phone number (972) 693-1944.

The CLIA number assigned to this NPI record is 45D2004396 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2017 and was last updated on 4/7/2017.

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	363LF0000X	Nurse Practitioner	Family	AP131702	TEXAS	Yes

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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