Dfmed Zavalla LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

DFMED ZAVALLA LLC

Doing business as

Zavalla Family Medical Clinic

Practice address

153 Barge Rd
Zavalla, TX 75980-3003

Phone

(936) 897-1002

Fax

(936) 647-1041

NPI assigned

May 31, 2017

Last updated

Oct 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Young Jr., PA-CNPI 1184719486

Title

Physician

Phone

(936) 897-1002

Specialties & licenses 2

Addresses

Other names 1

• ZAVALLA FAMILY MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114455375. Details of each certification follow.

• CCN 673946 Rural health clinic · Active · Details

Rural health clinic certification: CCN 673946

Legal name

DFMED ZAVALLA LLC

Doing business as

ZAVALLA FAMILY MEDICAL CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jul 24, 2019

Last certification

Jul 14, 2025

Ownership / control type

1C

Organization structure

LLCProprietary

Incorporated

Dec 20, 2017 in TX

Enrollment address

153 Barge Rd
Zavalla, TX 75980-3003

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Robert A Young Jr., PAC

  • Medical Physician Assistant
  • Zavalla, TX
  • NPI 1184719486

  5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert A Young Jr., PAC

  • Medical Physician Assistant
  • Zavalla, TX
  • NPI 1184719486
  Medicare reassignment Authorized official
• Joshua Dewayne Allen, D.O.

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1982904033

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1114455375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 594",
            "city": "ZAVALLA",
            "state": "TX",
            "postal_code": "75980",
            "telephone_number": "936-897-1002",
            "fax_number": "936-647-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BARGE RD",
            "city": "ZAVALLA",
            "state": "TX",
            "postal_code": "759803003",
            "telephone_number": "936-897-1002",
            "fax_number": "936-647-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFMED ZAVALLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2024-10-17",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "936-897-1002",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZAVALLA FAMILY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ZAVALLA FAMILY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thaffy Brashear
• Elizabeth Hanks Dunbar, MP
• Robert A Young Jr., PAC
• Zavalla Isd

• Rural Health Clinic/Center in Zavalla, TX
• Providers in Zavalla, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.