NPIMap

Organization Active NPI

Southern Medical Family Clinic, Inc.

  • General Practice Physician
  • Carrollton, TX
National Provider Identifier
1861628117
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
M3680 Issued in TX
Legal business name
SOUTHERN MEDICAL FAMILY CLINIC, INC.
Doing business as
Carrollton Medical &Health Clinic PLLC
Practice address
1927 E Belt Line Rd Ste 146
Carrollton, TX 75006-5814
Phone
(972) 820-8662
Fax
(972) 820-8664
NPI assigned
Jun 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Authorized official

Name
Mr. PA Nous Pan
Title
Executive Director
Phone
(972) 820-8662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X M3680 TX Primary

Addresses

Primary practice location

1927 E Belt Line Rd Ste 146
Carrollton, TX 75006-5814

Mailing address

1927 E Belt Line Rd Ste 146
Carrollton, TX 75006-5814
Phone (972) 820-8662

Other names 1

  • Carrollton Medical &Health Clinic PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carrollton Medical Health Clinic PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243814400000",
    "number": "1861628117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 E BELT LINE RD STE 146",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750065814",
            "telephone_number": "972-820-8662",
            "fax_number": "972-820-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 E BELT LINE RD STE 146",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750065814",
            "telephone_number": "972-820-8662",
            "fax_number": "972-820-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL FAMILY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "PA",
        "authorized_official_middle_name": "NOUS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "972-820-8662",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "M3680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carrollton Medical &Health Clinic PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.