DFW Super Group I LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

DFW SUPER GROUP I LLC

Practice address

3020 Legacy Dr
Ste. 100-399
Plano, TX 75023-8322

Phone

(214) 632-3514

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Lana S. Ralston, F.N.P.

Title

Manager

Phone

(214) 632-3514

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahalia L Jackson-Butler, DNP, APRN

  • Primary Care Nurse Practitioner
  • Bedford, TX
  • NPI 1063669893
  NPD (past)
• Nuggehalli Neil Satyu, M.D.

  • Family Medicine Physician
  • Terrell, TX
  • NPI 1821015587
  NPD (past)
• Tamara Ann Tello, APRN

  • Family Nurse Practitioner
  • Nashua, NH
  • NPI 1528082955
  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1275575755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835850",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750835850",
            "telephone_number": "972-680-1577",
            "fax_number": "972-690-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 LEGACY DR",
            "address_2": "STE. 100-399",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750238322",
            "telephone_number": "214-632-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFW SUPER GROUP I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "LANA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-632-3514",
        "authorized_official_credential": "F.N.P."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DFW Mdcare PLLC
• DFW Orthotics and Prosthetics, LLC
• DFW Plano Emergency Center, LLC (Signature Care Emergency Center - Plano)
• DFW Preston Emergency Center LLC (Signaturecare Emergency Center Preston)
• DFW Sleep Solutions LLC
• DFW Wellness Center
• DFW Works
• DFW Wound & Hyperbarics, P.a.
• DFW-Hospital Medicine Consultants PLLC
• DH Care Services LLC

• Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.