Broadway I-30 Medical Clinic, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F0154 Issued in TX

Legal business name

BROADWAY I-30 MEDICAL CLINIC, PLLC

Practice address

407 W Interstate 30
Garland, TX 75043-5912

Phone

(972) 240-8539

Fax

(972) 303-1994

NPI assigned

Jul 6, 2016

Organization subpart

No

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

Authorized official

Name

Carlton K Clarke, MD

Title

Medical Director-Owner

Phone

(214) 803-4516

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Hornsby, NP

  • Family Nurse Practitioner
  • Garland, TX
  • NPI 1417256439
  NPD (past)

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1992157697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W INTERSTATE 30",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435912",
            "telephone_number": "972-240-8539",
            "fax_number": "972-303-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W INTERSTATE 30",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435912",
            "telephone_number": "972-240-8539",
            "fax_number": "972-303-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY I-30 MEDICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR-OWNER",
        "authorized_official_telephone_number": "214-803-4516",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F0154",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L4890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Darnell Bridges, MD
• Bright Smiles of Garland PLLC
• Bright White Dental
• Christina Brink
• Broadway Family Dentistry PLLC
• Broadway Pharmacy LLC
• Broadway Psychiatry LLC
• Richard John Brock, CRNA
• Bronse International
• Jacqueline Renea Brooks

• Family Medicine Physician in Garland, TX
• Providers in Garland, 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 Jul 6, 2016; 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.