Organization Active NPI

TLC Family Clinic PLLC

  • Primary Care Clinic/Center
  • Lake Jackson, TX
National Provider Identifier
1093453201
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TLC FAMILY CLINIC PLLC
Practice address
230 Parking Way St
Lake Jackson, TX 77566-5227
Phone
(979) 313-6278
Fax
(979) 401-4175
NPI assigned
May 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yolanda Deleon
Title
Front Office
Phone
(979) 313-6278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

230 Parking Way St
Lake Jackson, TX 77566-5227

Mailing address

230 Parking Way St
Lake Jackson, TX 77566-5227
Phone (979) 313-6278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231109000141 TX Part B Supplier - Clinic/Group Practice 7214384478 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Jackson, TX

National Provider Directory

National Provider Directory

Locations

230 Parking Way St
Lake Jackson, TX 77566
Phone (979) 313-6278

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1093453201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PARKING WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665227",
            "telephone_number": "979-313-6278",
            "fax_number": "979-401-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PARKING WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665227",
            "telephone_number": "979-313-6278",
            "fax_number": "979-401-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC FAMILY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "DELEON",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "FRONT OFFICE",
        "authorized_official_telephone_number": "979-313-6278"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.