Organization Active NPI

Family Medicine Clinic PLLC

  • Family Medicine Physician
  • Farmers Branch, TX
National Provider Identifier
1417767385
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY MEDICINE CLINIC PLLC
Practice address
10 Medical Pkwy Ste 208
Farmers Branch, TX 75234-7845
Phone
(972) 243-9607
Fax
(972) 488-3323
NPI assigned
Jan 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Dr. Humberto Lopez Jr., DONPI 1588924369
Title
President
Phone
(972) 243-9607

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10 Medical Pkwy Ste 208
Farmers Branch, TX 75234-7845

Mailing address

10 Medical Pkwy Ste 208
Farmers Branch, TX 75234-7845
Phone (972) 243-9607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250714003229 TX Part B Supplier - Clinic/Group Practice 7810402393 Receives reassigned benefits from 2 practitioners
Practice locations: Farmers Branch, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2331248Family Medicine Clinic PLLC10 Medical Parkway Plaza 3 Suite 208, Farmers Branch, TX 75234Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Locations

10 Medical Pkwy
Ste 208
Farmers Branch, TX 75234
Phone (972) 243-9607

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1417767385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PKWY STE 208",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752347845",
            "telephone_number": "972-243-9607",
            "fax_number": "972-488-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PKWY STE 208",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752347845",
            "telephone_number": "972-243-9607",
            "fax_number": "972-488-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "HUMBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-243-9607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmers Branch, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.