DFW Lao Heritage

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DFW LAO HERITAGE

Practice address

10716 Galveston PL
McKinney, TX 75071-1360

Phone

(972) 689-8212

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Peter Southidara

Title

Executive Director

Phone

(972) 689-8212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1326664905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10716 GALVESTON PL",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750711360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10716 GALVESTON PL",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750711360",
            "telephone_number": "972-689-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFW LAO HERITAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "SOUTHIDARA",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "972-689-8212"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shala Devlin, PHARMD, RPH
• John M Devore, DC
• Dewayne Smith
• Ian Thomas Dewey, BCBA
• Blessing E. Dexter, LPCS, LSSP
• DFW Sports Medicine, PLLC
• Diamondback Medical LLC
• Diamondback Medical Solutions PLLC
• Elaine Maria Dibartolo, LPC-ASSOCIATE
• Nick Dietrick, LPC

• Home Health Agency in McKinney, TX
• Providers in McKinney, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.