MC Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MC MEDICAL LLC

Practice address

555 W Interstate 30
Garland, TX 75043-5702

Phone

(972) 535-1562

Fax

(972) 303-2101

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Richard Henry

Title

Enrollment Manager

Phone

(479) 258-2080

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Walmart Health Doing business as
• Walmart Care Clinic 10-3224 Other name

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1841607082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-204-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W INTERSTATE 30",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435702",
            "telephone_number": "972-535-1562",
            "fax_number": "972-303-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "479-258-2080"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "358652ZHTN",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walmart Care Clinic 10-3224",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Walmart Care Clinic 10-3224",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Mays
• Toochukwu Endaline Mba
• Laura Mbassi
• Ngomeni M Mbilikira, PMHNP
• MBKC Care Inc
• Laura A McAda, LPC(A)
• Jane Yatta McArthy, APRN
• Delores Franklin McClean, LCSW
• Ronald J McCollum, M.D.
• Madison McConnell, OTD, OTR/L

• General Practice Physician in Garland, TX
• Providers in Garland, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.