NPIMap

Organization Active NPI

Centro de Mi Salud

  • Psychologist
  • Dallas, TX
National Provider Identifier
1306090501
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CENTRO DE MI SALUD
Practice address
628 Centre St
Dallas, TX 75208-6328
Phone
(214) 941-0798
Fax
(214) 941-0408
NPI assigned
Nov 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Mr. Juan G. Estrada, BA PHYCOLOGY
Title
QMHP
Phone
(214) 941-0798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

628 Centre St
Dallas, TX 75208-6328

Mailing address

628 Centre St
Dallas, TX 75208-6328
Phone (214) 941-0798

Other identifiers 1

IdentifierTypeStateIssuer
1043204019MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Centro de Mi Salud5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

628 Centre St
Dallas, TX 75208
Phone (214) 941-0798

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1306090501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CENTRE ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086328",
            "telephone_number": "214-941-0798",
            "fax_number": "214-941-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CENTRE ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086328",
            "telephone_number": "214-941-0798",
            "fax_number": "214-941-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE MI SALUD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "ESTRADA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "QMHP",
        "authorized_official_telephone_number": "214-941-0798",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA PHYCOLOGY"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043204019",
            "state": "TX"
        }
    ],
    "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 Nov 14, 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.