| Mid Cities Health LLC | |
|
1615 Lancaster Dr Ste 107 Grapevine TX 76051-2111 | |
| (817) 510-9645 | |
| (817) 685-6047 |
| Full Name | Mid Cities Health LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1615 Lancaster Dr Ste 107, Grapevine, Texas |
| Authorized Official Name and Position | Saba Shabnam (MEDICAL DIRECTOR / OWNER) |
| Authorized Official Contact | 8177760605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Cities Health LLC Po Box 93329 Southlake TX 76092-0113 Ph: (817) 776-0605 | Mid Cities Health LLC 1615 Lancaster Dr Ste 107 Grapevine TX 76051-2111 Ph: (817) 510-9645 |
| NPI Number | 1679967145 |
|---|---|
| Provider Enumeration Date | 03/23/2015 |
| Last Update Date | 12/05/2025 |
| Certification Date | 12/05/2025 |
| Medicare PECOS PAC ID | 1052623048 |
|---|---|
| Medicare Enrollment ID | O20150706000602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679967145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M2797 (Texas) | Primary |
| Provider Name | Saba Shabnam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225091655 PECOS PAC ID: 8921049784 Enrollment ID: I20070525000542 |
| Provider Name | Sydney Lyn Clayton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710780150 PECOS PAC ID: 0345725990 Enrollment ID: I20260331004393 |
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