South Polk Medical Clinic Llc in Dallas - Nurse Practitioner
South Polk Medical Clinic Llc - NPI 1043351760
South Polk Medical Clinic Llc is a Nurse Practitioner in Dallas, Texas. South Polk Medical Clinic Llc practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for South Polk Medical Clinic Llc is 1043351760. The last update date is 2011-07-26.
South Polk Medical Clinic Llc's current location address is 3436 S Polk St, Dallas, Texas. You can contact this provider via phone number 2143721051 and fax number 2143729201. The mailing address for South Polk Medical Clinic Llc is 3436 S Polk St, Dallas, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Polk Medical Clinic Llc |
|---|---|
| Address | 3436 S Polk St, Dallas, Texas |
| Phone Number | 2143721051 |
| Fax Number | 2143729201 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | VICE PRESI |
|---|---|
| Authorized Official Name | Roberts El Greco |
| Telephone Number | 2143721051 |
NPI Number Detail
| NPI Number | 1043351760 |
|---|---|
| Provider Enumeration Date | 2007-02-08 |
| Last Updated Date | 2011-07-26 |
Provider Mailing Address Detail
| Address | 3436 S Polk St |
|---|---|
| City | Dallas |
| State | Texas (TX) |
| Post Code | 752243804 |
| Phone Number | 2143721051 |
| Fax Number | 2143729201 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 578285 |
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Definition: (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 certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 155741503 | TX | -- | |
| 190227201 | TX | -- | |
| 0041PN | TX | BLUE CROSS BLUE SHIELD OF TEXA | |
| 7149594 | TX | AETNA | |
| 155741504 | TX | -- | |
| 4567567 | TX | CIGNA | |
| 190227202 | TX | -- | |
| 10008701 | TX | AMERIGROUP | |
| 562313709 | TX | OLD TAX ID | |
| NP7128 | TX | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to South Polk Medical Clinic Llc by the Centers for Medicare & Medicaid Services?
The South Polk Medical Clinic Llc has been assigned the NPI (National Provider Identifier) 1043351760. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where South Polk Medical Clinic Llc's facilities are situated?
The facilities of South Polk Medical Clinic Llc are physically located at the following address: 3436 S Polk St, Dallas, TX, 752243804.
What is the area of specialization for South Polk Medical Clinic Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for South Polk Medical Clinic Llc is Nurse Practitioner, and the corresponding taxonomy code that categorizes this area of expertise is 363L00000X.
When did the South Polk Medical Clinic Llc receive its 1043351760?
The South Polk Medical Clinic Llc was issued its 1043351760 on 2007-02-08, which is the date when the organization was assigned this unique identifier.
When was the information related to South Polk Medical Clinic Llc most recently updated or refreshed?
The details pertaining to the South Polk Medical Clinic Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2011-07-26.