| Clinica Guadalupe Grand Plaza,llc | |
|
4200 South Fwy Ste 15 Fort Worth TX 76115-1423 | |
| (469) 931-2538 | |
| Not Available |
| Full Name | Clinica Guadalupe Grand Plaza,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4200 South Fwy Ste 15, Fort Worth, Texas |
| Authorized Official Name and Position | Cindy Olalde (OFFICER) |
| Authorized Official Contact | 2142401506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Guadalupe Grand Plaza,llc 14951 Dallas Pkwy Ste 190 Dallas TX 75254-6894 Ph: () - | Clinica Guadalupe Grand Plaza,llc 4200 South Fwy Ste 15 Fort Worth TX 76115-1423 Ph: (469) 931-2538 |
| NPI Number | 1316633043 |
|---|---|
| Provider Enumeration Date | 04/14/2023 |
| Last Update Date | 04/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316633043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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