White Rock Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

K9223 Issued in TX

Legal business name

WHITE ROCK CLINIC LLC

Practice address

9102 Garland Rd
Dallas, TX 75218-3901

Phone

(214) 327-2883

Fax

(214) 327-2471

NPI assigned

Mar 11, 2010

Last updated

Mar 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raul A Lozano, PA-C

Title

President

Phone

(214) 327-2883

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1396068805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183901",
            "telephone_number": "214-327-2883",
            "fax_number": "214-327-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9102 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183901",
            "telephone_number": "214-327-2883",
            "fax_number": "214-327-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE ROCK CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "LOZANO",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-327-2883",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "K9223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.