OLD NORTHEAST DALLAS FAMILY MEDICAL ASSOCIATION, P.A. (NPI# 1497701528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497701528 |
| Entity Type | Organization |
| Organization Name | OLD NORTHEAST DALLAS FAMILY MEDICAL ASSOCIATION, P.A. |
| Other Organization Name | PATIENT PLACE |
| Practice Address |
2636 W Walnut St Garland TX 75042-6441 |
| Practice Telephone | 9724875800 |
| Practice Fax Number | 9724879680 |
| Mailing Telephone | 9724875800 |
| Mailing Fax Number | 9724879680 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2014-02-04 |
| Authorized Official Name | JAMES W. BLAMER (COO) |
| Authorized Official Telephone | 2143337333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | TX | Chiropractic Providers | |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
TX | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 092051401 | 05 |
| Other Name | Type Code |
|---|---|
| Patient Place | Doing Business As Name - Organization |
| Street Address |
2636 W WALNUT ST |
| City | GARLAND |
| State | TX |
| Zip Code | 75042-6441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912569708 | Sheree-dawn Rivera | Nurse Practitioner | 2636 W Walnut St, Garland, TX 75042-6485 | 2019-07-02 |
| 1306372347 | Carmelina Marin | Physician Assistant | 2636 W Walnut St, Garland, TX 75042-6485 | 2017-05-11 |
| 1265762363 | Glenn G Deshaw Od Pa | Optometrist | 2636 W Walnut St, Ste. 200, Garland, TX 75042-6441 | 2010-01-12 |
| 1093929507 | Emmanuel Azu Omehe | Pharmacist | 2636 W Walnut St, Ste 300, Garland, TX 75042-6441 | 2007-05-10 |
| 1811081490 | Maria Esther Solares | Physician Assistant | 2636 W Walnut St, Garland, TX 75042 | 2006-10-03 |
| 1720015167 | Ngoc-oanh Nguyen-tong | Chiropractor | 2636 W Walnut St, Garland, TX 75042-6441 | 2006-06-28 |
| 1346284643 | Glenn Gordon Deshaw | Optometrist | 2636 W Walnut St, Ste 200, Garland, TX 75042-6441 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699259697 | Abiodun Gloria Irabor-musa | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3106 Centennial Dr, Garland, TX 75042 | 2018-09-17 |
| 1356870620 | Brad Taylor Landrum | Family Medicine | 601 Clara Barton Blvd., Suite 340, Garland, TX 75042 | 2017-06-08 |
| 1043662034 | Alicia Valdiviezo | Physician Assistant | 2046 Forest Ln Ste 130, Garland, TX 75042 | 2016-07-01 |
| 1053711184 | Jamette Hickman | Physical Therapist | 705 Walter Reed Blvd Suite 100, Garland, TX 75042 | 2014-08-26 |
| 1619397932 | Saint Catherine Hospice Inc. | Hospice, Inpatient | 4229 Glenhaven Drive, Garland, TX 75042 | 2014-04-25 |
| 1821424094 | Angel Care Team | Adult Companion | 1801 Evelyn Dr., Garland, TX 75042 | 2013-09-19 |
| 1427311042 | Baylor Family Medicine Clinic | Case Manager/Care Coordinator | 601 Clara Barton, 340, Garland, TX 75042 | 2012-06-19 |
| 1003176959 | Benedict Eric Homer | Dentist | 813 North Jupiter Rd., Garland, TX 75042 | 2012-05-25 |
| 1518254929 | Rama Sulochana Narla | Emergency Medicine | 601, Clara Barton Blvd, Ste 340, Garland, TX 75042 | 2011-07-06 |
| 1093002917 | Mecca Group | Community/Behavioral Health | 1213 Patricia Ln, Garland, TX 75042 | 2011-06-29 |
| Find all providers in zip 75042 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033764162 | Avery James LLC | Family Medicine | 6330 Broadway Blvd Ste C, Garland, TX 75043-5956 | 2019-08-06 |
| 1831665272 | Md24 Tx, Pa | Family Medicine | 675 Town Square Blvd Ste 200, Garland, TX 75040-2991 | 2018-10-23 |
| 1255822383 | Mixon Integrated Health Pllc | Family Medicine | 1919 S Shiloh Rd Ste 107, Garland, TX 75042-8234 | 2018-05-24 |
| 1568982304 | Wholistic Healthcare Solutions: Mind, Body & Spirit, Pllc | Family Medicine | 6309 Fallbrook Dr, Garland, TX 75043-5920 | 2017-06-22 |
| 1356870620 | Brad Taylor Landrum | Family Medicine | 601 Clara Barton Blvd., Suite 340, Garland, TX 75042 | 2017-06-08 |
| 1194179580 | Kai-soon Yang | Family Medicine | 4430 Lavon Dr Ste 350, Garland, TX 75040-2976 | 2016-04-21 |
| 1407286040 | Rose Garden Housecall Services, LLC | Family Medicine | 829 Villa Ridge Dr, Garland, TX 75043-2660 | 2013-11-18 |
| 1265704779 | Medical Billing Usa | Family Medicine | 4141 Easton Meadows Dr, 202, Garland, TX 75043-2048 | 2012-01-30 |
| 1417243247 | Chene Tamyron Smith | Family Medicine | 5345 N George Bush Hwy, Garland, TX 75040-2767 | 2011-06-20 |
| 1649596396 | The Medical Equipment Group, Inc. | Family Medicine | 5915 Murphy Rd Ste 100, Garland, TX 75048-2825 | 2010-04-19 |
| Find all providers in GARLAND | ||||
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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.