Mission East Dallas and Metroplex Project, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MISSION EAST DALLAS AND METROPLEX PROJECT, INC.

Practice address

4650 President George Bush Hwy
Sachse, TX 75048

Phone

(972) 682-8917

NPI assigned

Dec 1, 2022

Last updated

Dec 1, 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

Charles Joseph Wiltraut

Title

Ceo

Phone

(972) 682-8917

Specialties & licenses 1

Addresses

Tax ID family

Mission East Dallas and Metroplex Project Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mission East Dallas and Metroplex Project, Inc.

  dba Missoin East Dallas

  • Dentist
  • Mesquite, TX
  • NPI 1043662885
  NPD tax ID
• Mission East Dallas and Metroplex Project, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sunnyvale, TX
  • NPI 1992416259
  NPD tax ID

Locations

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1922718816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 GUS THOMASSON RD STE 40",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501758",
            "telephone_number": "972-682-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 PRESIDENT GEORGE BUSH HWY",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "75048",
            "telephone_number": "972-682-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION EAST DALLAS AND METROPLEX PROJECT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "WILTRAUT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-682-8917"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donelle Lynn Messina, RN
• Michelle Musson PLLC
• Dejene L Mideksa
• Amy B Miller, D.O.
• Kimberly Nicole Mills, FNP-C
• Rebecca Allison Mitcham
• Hana Mohamad
• Chantal Youbi Mondji
• More Life Chiropractic & Wellness (Pinnacle Health Center)
• Larissa Morris, LPC

• Federally Qualified Health Center (FQHC) in Sachse, TX
• Providers in Sachse, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

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