Active NPI
Roosevelt King Jr.
- Assisted Living Facility
- Dallas, TX
National Provider Identifier
1659568905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 119896
- Practice address
- 2923 Gladiolus LN
Dallas, TX 75233-3905 - Phone
- (214) 808-2608
- Fax
- (214) 331-3086
- NPI assigned
- Oct 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 119896 | TX | Primary |
Addresses
Primary practice location
2923 Gladiolus LN
Dallas, TX 75233-3905
Mailing address
2923 Gladiolus LN
Dallas, TX 75233-3905
Phone (214) 808-2608
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119896 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786838400000",
"number": "1659568905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2923 GLADIOLUS LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752333905",
"telephone_number": "214-808-2608",
"fax_number": "214-331-3086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2923 GLADIOLUS LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752333905",
"telephone_number": "214-808-2608",
"fax_number": "214-331-3086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "ROOSEVELT",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-01",
"last_updated": "2026-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "TX",
"license": "119896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.