Individual provider Active NPI

Juan Carlos Gavalda, M.D.

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1992062160
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q4956 Issued in TX
Practice address
820 S Carrier Pkwy
Grand Prairie, TX 75051-1517
Phone
(972) 262-1425
Fax
(972) 262-4973
NPI assigned
Apr 12, 2012
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q4956 TX Primary
Family Medicine Physician 207Q00000X 18844 PR

Addresses

Primary practice location

820 S Carrier Pkwy
Grand Prairie, TX 75051-1517

Mailing address

820 S Carrier Pkwy
Grand Prairie, TX 75051-1517
Phone (972) 262-1425

Other practice location 1

4200 South Fwy Ste 1990
Fort Worth, TX 76115-1415
Phone (682) 786-2445

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address juan.carlos.gavalda.1@29601.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150903001069 TX Practitioner - Family Practice 4082920129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Puerto Rico School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4200 S Fwy
Suite 1990
Fort Worth, TX 76115-1415
Phone (682) 990-6491

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18844PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Jul 20, 2015 Accepting new patients
Centerwell Senior Primary Care (TX) PA Family Medicine CurrentSince Sep 16, 2024 Accepting new patients
Centerwell Senior Primary Care (TX) PA Family Medicine CurrentSince Sep 16, 2024 Accepting new patients
Centerwell Senior Primary Care (TX) PA Family Medicine Current Accepting new patients
Medhealth Family Medicine CurrentSince Jul 20, 2015 Accepting new patients
Centerwell Senior Primary Care (TX) PA Family Medicine Past Accepting new patients
Afridi Heart Care, P.L.L.C. PastSince Oct 10, 2021 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

4200 South Fwy
Ste 1990
Fort Worth, TX 76115
Phone (682) 990-6491

820 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (972) 262-1425

3915 Spencer Hwy
Pasadena, TX 77504
Phone (713) 265-6955

Interoperability endpoints

  • Direct secure messaging: juan.carlos.gavalda.1@29601.direct.athenahealth.com
  • Direct secure messaging: juan.gavalda@centerwell.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Texas Life Hospice - Fort WorthMansfield, TX, CCN 971525 Hospice Contracted Managing Employee (100%) Jan 1, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1992062160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511517",
            "telephone_number": "972-262-1425",
            "fax_number": "972-262-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511517",
            "telephone_number": "972-262-1425",
            "fax_number": "972-262-4973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 South Fwy Ste 1990",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761151415",
            "country_code": "US",
            "telephone_number": "682-786-2445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVALDA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q4956",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "18844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "juan.carlos.gavalda.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "4200 South Fwy Ste 1990",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761151415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.