NPIMap

Organization Active NPI

Clinica Guadalupe Fort Worth LLC

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1740972777
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA GUADALUPE FORT WORTH LLC
Practice address
2566 Gus Thomasson Rd
Dallas, TX 75228-3017
Phone
(469) 399-1000
NPI assigned
May 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Authorized official

Name
Cynthia Olalde
Title
Executive Adminstrator
Phone
(214) 240-1506

Specialties & licenses 1

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

Addresses

Primary practice location

2566 Gus Thomasson Rd
Dallas, TX 75228-3017

Mailing address

2566 Gus Thomasson Rd
Dallas, TX 75228-3017
Phone (469) 399-1000

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": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1740972777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2566 GUS THOMASSON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283017",
            "telephone_number": "469-399-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2566 GUS THOMASSON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283017",
            "telephone_number": "469-399-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA GUADALUPE FORT WORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "OLALDE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "EXECUTIVE ADMINSTRATOR",
        "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": []
}

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 May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.