Organization Active NPI

Consultorio General Hispano

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1528642402
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CONSULTORIO GENERAL HISPANO
Practice address
2502 S Belt Line Rd Ste 400
Grand Prairie, TX 75052-5398
Phone
(214) 347-3619
NPI assigned
May 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Antonio Brizuela, NP
Title
Provider
Phone
(214) 497-7346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2502 S Belt Line Rd Ste 400
Grand Prairie, TX 75052-5398

Mailing address

2502 S Belt Line Rd Ste 400
Grand Prairie, TX 75052-5398
Phone (214) 347-3619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210707000862 TX Part B Supplier - Clinic/Group Practice 6305248832 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Prairie, 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
45D2243722Consultorio General Hispano2502 S Belt Line Rd Suite 400, Grand Prairie, TX 75052Certificate of waiverNov 21, 2027

National Provider Directory

National Provider Directory

Locations

2502 S Belt Line Rd
Grand Prairie, TX 75052

2502 S Belt Line Rd
Ste 400
Grand Prairie, TX 75052
Phone (214) 347-3619

Practitioners & affiliated clinicians

Practitioners 4

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": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1528642402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 S BELT LINE RD STE 400",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750525398",
            "telephone_number": "214-347-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 S BELT LINE RD STE 400",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750525398",
            "telephone_number": "214-347-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTORIO GENERAL HISPANO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "BRIZUELA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "214-497-7346",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.