LBU HEALTH CENTER SOUTH (NPI# 1104476431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104476431 |
| Entity Type | Organization |
| Organization Name | LBU HEALTH CENTER SOUTH |
| Other Organization Name | LBU HEALTH CENTER SOUTHERN CAMPUS |
| Practice Address |
5787 S Hampton Rd Ste 365 Dallas TX 75232-6336 |
| Mailing Address |
809 Singleton Blvd Dallas TX 75212-4014 |
| Practice Telephone | 2145400300 |
| Mailing Telephone | 2145400300 |
| Mailing Fax Number | 2145400308 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | ANGIE CRAGI (REVENUE CYCLE MANAGER) |
| Authorized Official Telephone | 2145400300 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LBU Health Center Southern Campus | Doing Business As Name - Organization |
| Street Address |
5787 S HAMPTON RD STE 365 |
| City | DALLAS |
| State | TX |
| Zip Code | 75232-6336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705348 | Kimberly Mitchell | Technician | 5645 Elm Valley Ln, Dallas, TX 75232 | 2019-11-27 |
| 1457900607 | Jewelene Colbert | Technician | 1630 Oak Glen Trl., Dallas, TX 75232 | 2019-09-10 |
| 1700330032 | Ahad G Sheikh | Dentist | 4767 Vista Woods Blvd, Dallas, TX 75232 | 2016-08-03 |
| 1962881748 | Legacy Dental of Glen Oaks | Dentist | 4767 Vista Wood Blvd, Ste 110, Dallas, TX 75232 | 2015-05-26 |
| 1003234147 | Crystal Smith | Homeopath | 6923 Coleshire Dr, Dallas, TX 75232 | 2014-04-05 |
| 1356782098 | Sonja Lynette Shipp | Counselor | 5787 South Hampton Road, Suite 230-k, Dallas, TX 75232 | 2013-07-10 |
| 1073856233 | Heart To Heart Hospice of Dallas, LLC | Hospice Care, Community Based | 5787 S Hampton Rd Ste 430, Dallas, TX 75232 | 2013-04-05 |
| 1700131976 | Vivian Kay Thompson | Counselor | 5034 Haywood Pkwy, Dallas, TX - TEXAS 75232 | 2012-07-13 |
| 1821379819 | Cts - Cotton Traveling Service | Bus | 539 Meadow Health Lane, Dallas, TX 75232 | 2011-09-02 |
| 1467696781 | Faith Residential House Inc #1 | Exclusive Provider Organization | 6840 Brierfield Cir, Dallas, TX 75232 | 2009-04-30 |
| Find all providers in zip 75232 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.