NPIMap

Organization Active NPI

Clinica Guadalupe Garland, LLC

  • Family Medicine Physician
  • Garland, TX
National Provider Identifier
1639889306
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA GUADALUPE GARLAND, LLC
Practice address
1912 S 1St St
Garland, TX 75040-8409
Phone
(469) 931-2538
Fax
(469) 931-2537
NPI assigned
Dec 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Cindy Olalde
Title
Office Manager
Phone
(214) 240-1506

Specialties & licenses 1

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

Addresses

Primary practice location

1912 S 1St St
Garland, TX 75040-8409

Mailing address

14951 Dallas Pkwy Ste 190
Dallas, TX 75254-6894

Other names 1

  • Clinica Familiar La Virgen de Guadalupe Doing business as

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
45D2260211Clinica Familar la Virgen de Guadalupe - Garland1912 S 1St St, Garland, TX 75040Certificate of waiverMay 15, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1639889306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14951 DALLAS PKWY STE 190",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752546894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 S 1ST ST",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750408409",
            "telephone_number": "469-931-2538",
            "fax_number": "469-931-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA GUADALUPE GARLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "OLALDE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-240-1506"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Familiar La Virgen de Guadalupe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.