Martin Luther King Jr Family Clinic

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MARTIN LUTHER KING JR FAMILY CLINIC

Practice address

10327 Rylie Rd Ofc 4
Dallas, TX 75217-8240

Phone

(214) 426-3645

Fax

(214) 446-2018

NPI assigned

Feb 11, 2022

Organization subpart

No

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

Authorized official

Name

Jolie Lyon Allen

Title

Coo

Phone

(214) 426-3645

Specialties & licenses 1

Addresses

Tax ID family

Martin Luther King Fam3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Martin Luther King Jr Family Clinic

  • Public Health or Welfare Agency
  • Dallas, TX
  • NPI 1841288602
  NPD tax ID
• Martin Luther King, Jr. Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Balch Springs, TX
  • NPI 1407274855
  NPD tax ID

Locations

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1225782824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150128",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753150128",
            "telephone_number": "214-426-3645",
            "fax_number": "214-446-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10327 RYLIE RD OFC 4",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752178240",
            "telephone_number": "214-426-3645",
            "fax_number": "214-446-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN LUTHER KING JR FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JOLIE",
        "authorized_official_middle_name": "LYON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "214-426-3645"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Martilik, LPC
• Concepcion Martin de Bustamante
• Martin H. Schaffer M.D.,P.a.
• Maureen Virginia Martin Jamieson, DC
• Martin Luther King Jr Family Clinic
• Martin Luther King Jr Family Clinic
• Martin Luther King Jr Family Clinic
• Martin McElya DO PA
• Martin S.Posner MD Associated
• Leidy Daniela Martin Samudio

• Federally Qualified Health Center (FQHC) in Dallas, TX
• Providers in Dallas, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.