CLINICA LATINA FAMILIAR 1 LLC NPI 1790556710

NPI Information

NPI: 1790556710
Provider Name: CLINICA LATINA FAMILIAR 1 LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 45D2112222

Address:
31315 FM 2920 RD STE 9
WALLER, TX
ZIP 77484
Phone: (936) 372-3000
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CLINICA LATINA FAMILIAR 1 LLC is a family nurse practitioner in Waller, TX. CLINICA LATINA FAMILIAR 1 LLC NPI is 1790556710. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

31315 FM 2920 RD STE 9
WALLER, TX
ZIP 77484-021
Phone: (936) 372-3000
Fax: (936) 372-3009

The provider's authorized official is Maydelis Suarez .
The authorized official title is Medical Provider and has the following contact phone number (386) 205-4365.

The CLIA number assigned to this NPI record is 45D2112222 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/9/2024 and was last updated on 1/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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