Organization
CLINICA GUADALUPE GRAND PLAZA,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY OLALDE (OFFICER)
(214) 240-1506
Entity
Organization
Contact information
Practice address
4200 SOUTH FWY STE 15, FORT WORTH, TX 76115-1423
(469) 931-2538
Mailing address
14951 DALLAS PKWY STE 190, DALLAS, TX 75254-6894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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