NPIMap

Organization Active NPI

Clinica Guadalupe Walnut Hill LLC

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1174219802
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA GUADALUPE WALNUT HILL LLC
Practice address
2555 Walnut Hill LN Ste 110
Dallas, TX 75229-5629
Phone
(972) 252-3700
Fax
(972) 252-3701
NPI assigned
Apr 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Authorized official

Name
Cindy Olalde
Title
Officer
Phone
(214) 240-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2555 Walnut Hill LN Ste 110
Dallas, TX 75229-5629

Mailing address

14951 Dallas Pkwy Ste 190
Dallas, TX 75254-6894

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
45D2265755Clinica Guadalupe Walnut Hill, LLC2555 Walnut Hill LN Suite 110, Dallas, TX 75229Certificate of waiverJan 28, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1681430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1174219802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14951 DALLAS PKWY STE 190",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752546894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 WALNUT HILL LN STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752295629",
            "telephone_number": "972-252-3700",
            "fax_number": "972-252-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA GUADALUPE WALNUT HILL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "OLALDE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "214-240-1506"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.