Active NPI
My Care on Demand LLC
- Family Medicine Physician
- Desoto, TX
National Provider Identifier
1255950002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MY CARE ON DEMAND LLC
- Practice address
- 2707 Bolton Boone Dr Ste 102
Desoto, TX 75115-2077 - Phone
- (469) 530-4990
- NPI assigned
- Apr 12, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Damian Irabor, FNP
- Title
- Member
- Phone
- (214) 356-5165
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Primary Care Clinic/Center | 261QP2300X | |||
| Urgent Care Clinic/Center | 261QU0200X |
Addresses
Primary practice location
2707 Bolton Boone Dr Ste 102
Desoto, TX 75115-2077
Mailing address
2707 Bolton Boone Dr Ste 102
Desoto, TX 75115-2077
Phone (469) 530-4990
Other names 1
- MyCare Family and Wellness Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2707 Bolton Boone Dr
Ste 102
Desoto, TX 75115
Phone (468) 530-4990
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Desoto, TX
- NPI 1285003236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586649600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730851200000",
"number": "1255950002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 BOLTON BOONE DR STE 102",
"city": "DESOTO",
"state": "TX",
"postal_code": "751152077",
"telephone_number": "469-530-4990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 BOLTON BOONE DR STE 102",
"city": "DESOTO",
"state": "TX",
"postal_code": "751152077",
"telephone_number": "469-530-4990"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MY CARE ON DEMAND LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-12",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A",
"authorized_official_last_name": "IRABOR",
"authorized_official_first_name": "DAMIAN",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "214-356-5165",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MyCare Family and Wellness Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Desoto, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.