South Dallas Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH DALLAS MEDICAL CENTER INC

Practice address

1709 Martin Luther King Jr Blvd Ste C
Dallas, TX 75215-3282

Phone

(469) 256-4063

Fax

(469) 305-7422

NPI assigned

Apr 8, 2020

Organization subpart

No

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

Authorized official

Name

Elizabeth Adebayo, APRN

Title

FNP-BC

Phone

(469) 305-7386

Specialties & licenses 1

Addresses

Other names 1

• SOUTH DALLAS MEDICAL CENTER INC Other name

Locations

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1831728179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 MARTIN LUTHER KING JR BLVD STE C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752153282",
            "telephone_number": "214-687-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MARTIN LUTHER KING JR BLVD STE C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752153282",
            "telephone_number": "469-256-4063",
            "fax_number": "469-305-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DALLAS MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-08",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "ADEBAYO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "FNP-BC",
        "authorized_official_telephone_number": "469-305-7386",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH DALLAS MEDICAL CENTER INC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SOUTH DALLAS MEDICAL CENTER INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• South Buckner Family Dentistry, PLLC
• South Carolina Outpatient Services, P.C.
• South Dallas Counseling
• South Dallas Dental PLLC
• South Dallas Eyecare
• South Dallas Sleep Center LLC
• South Dallas Therapy
• South First Dental of Oakcliff
• South Hampton Multi-Specialty Clinic
• South Loop 12 Medical Clinic LLC

• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.