Organization Active NPI

Los Barrios Unidos Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dallas, TX
National Provider Identifier
1164417085
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.
Practice address
809 Singleton Blvd
Dallas, TX 75212-4014
Phone
(214) 651-8739
Fax
(214) 237-9103
NPI assigned
Sep 16, 2005
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

Name
Ms. Leonor Marquez
Title
Ceo
Phone
(214) 540-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

809 Singleton Blvd
Dallas, TX 75212-4014

Mailing address

809 Singleton Blvd
Dallas, TX 75212-4014
Phone (214) 540-0300

Other identifiers 10

IdentifierTypeStateIssuer
10022414OtherTXAMERIGROUP
120977704MedicaidTX
120977705OtherTXCSHCN
3959OtherTXPARKLAND COMM.HEALTH PLAN
120977702MedicaidTX
10003276OtherTXAMERIGROUP
120977701MedicaidTX
120977703MedicaidTX
00P022OtherTXBLUE CROSS & BLUE SHIELD
G60091-01OtherTXDELTA DENTAL STATE GOV.PR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040618001005 TX Part B Supplier - Clinic/Group Practice 6103801881 Receives reassigned benefits from 4 practitioners
Practice locations: Dallas, TX
O20100528000508 TX Part A Provider - Federally Qualified Health Center (FQHC) 6103801881 Practice locations: Dallas, TX
O20201201000109 TX Part A Provider - Federally Qualified Health Center (FQHC) 6103801881 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dallas, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1164417085. Details of each certification follow.

Federally qualified health center certification: CCN 451810

Legal name
LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 28, 1971 in TX
Enrollment address
809 Singleton Blvd
Dallas, TX 75212-4014

Federally qualified health center certification: CCN 451129

Legal name
LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.
Doing business as
LBU HEALTH CENTER SOUTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 30, 2020
Last certification
Nov 30, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
5787 S Hampton Rd
Ste 365
Dallas, TX 75232-6336

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0699838Los Barrios Unidos Community Clinic-Adult,OB, Wic809 Singleton Blvd, Dallas, TX 75212Certificate of waiverSep 26, 2027

National Provider Directory

National Provider Directory

Locations

809 Singleton Blvd
Dallas, TX 75212
Phone (214) 540-0300

405 Stadium Dr
Grand Prairie, TX 75050
Phone (469) 865-1850

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Barbara S Baxter Individual Corporate DirectorBoard Member Jan 1, 1983
Larry Taylor Individual Corporate DirectorBoard Member Jan 1, 2010
Sharon J Davis Individual Corporate OfficerCmo Mar 23, 2015
W-2 Managing EmployeeCmo Mar 23, 2015
W-2 Managing EmployeeMD; Mar 23, 2015
Steve Salazar Individual Corporate DirectorBoard Member Jan 1, 1996
Margaret Hinguanzo Daugherty Individual Corporate DirectorBoard Member Jan 1, 2004
Maria Saavedra Individual Corporate DirectorBoard Member Dec 21, 2015
Sofia Garcia Individual Corporate DirectorBoard Member Jan 1, 2010
Tralan Chace Mathis Individual Corporate DirectorBoard Member Dec 1, 2019
Yesenia Banda Individual Corporate DirectorBoard Member Jan 1, 2019
Magdalena Wolters Individual Corporate DirectorBoard Member Jan 1, 2008
William Plaff Individual Corporate DirectorBoard Member May 1, 2018
Sherlyn V Samuel-Chibuzor Individual Corporate DirectorBoard Member Mar 1, 2022
Vickie Cedillo Individual Corporate DirectorBoard Member Jan 1, 2010
Leonor Marquez Individual Corporate OfficerCeo Oct 4, 2005
W-2 Managing EmployeeCeo Oct 4, 2005 100%
Contracted Managing EmployeeCfo Oct 3, 2005
Corporate OfficerCeo Oct 3, 2005
Katherine Elizabeth Sanchez Individual Corporate DirectorBoard Member Jan 1, 2013
Sheehan Rahman Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Los Barrios Unidos Community Clinic, Inc.Dallas, TX, CCN 671986 Federally qualified health center Operational/Managerial Control May 1, 2000

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1164417085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 SINGLETON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752124014",
            "telephone_number": "214-540-0300",
            "fax_number": "214-237-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 SINGLETON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752124014",
            "telephone_number": "214-651-8739",
            "fax_number": "214-237-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "LEONOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-540-0300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10022414",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120977704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "120977705",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARKLAND COMM.HEALTH PLAN",
            "identifier": "3959",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120977702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10003276",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120977701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120977703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "00P022",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL STATE GOV.PR",
            "identifier": "G60091-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.