Xtra Care Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

XTRA CARE CLINIC LLC

Practice address

10605 Boomer Cir Ste 105
Dallas, TX 75238-5392

Phone

(972) 365-0084

Fax

(214) 221-7199

NPI assigned

Aug 16, 2021

Last updated

Jan 18, 2022By 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

Evelyne ImahNPI 1407399645

Title

Owner

Phone

(972) 365-0084

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evelyne Motue Imah

  • Psychiatric/Mental Health Nurse Practitioner
  • Plano, TX
  • NPI 1407399645

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1699440214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SAINT THOMAS DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750944620",
            "telephone_number": "972-365-0084",
            "fax_number": "214-221-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BOOMER CIR STE 105",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752385392",
            "telephone_number": "972-365-0084",
            "fax_number": "214-221-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XTRA CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "IMAH",
        "authorized_official_first_name": "EVELYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-365-0084"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Xie, MD
• Joseph Xin, PA-C
• Ge Xiong, M.D.
• Yajie Xiong
• Zhenyu Xiong
• Xtreme Orthotics & Prosthetics, Inc
• Bobin Andrew Xu, DO
• Claire Xu
• Clayton Xu
• Hao Xu, MD

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.