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

341 Wheatfield Dr Ste 190
Sunnyvale, TX 75182-4639

Phone

(972) 682-8917

NPI assigned

Dec 7, 2022

Organization subpart

Yes

Parent organization

MISSION EAST DALLAS AND METROPLEX PROJECT, INCAs reported in NPPES

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

Part of

Mission East Dallas and Metroplex Project Inc

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.

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

  • Federally Qualified Health Center (FQHC)
  • Sachse, TX
  • NPI 1922718816
  NPD tax ID

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1992416259",
    "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": "341 WHEATFIELD DR STE 190",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824639",
            "telephone_number": "972-682-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION EAST DALLAS AND METROPLEX PROJECT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSION EAST DALLAS AND METROPLEX PROJECT, INC",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "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": []
}

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• Sam Molai, MD
• Sarah Kimberly Moore, AGNP
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• Federally Qualified Health Center (FQHC) in Sunnyvale, TX
• Providers in Sunnyvale, 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 7, 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.