Organization
CLINICA GUADALUPE FORT WORTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA OLALDE (EXECUTIVE ADMINSTRATOR)
(214) 240-1506
Entity
Organization
Contact information
Practice address
2566 GUS THOMASSON RD, DALLAS, TX 75228-3017
(469) 399-1000
Mailing address
2566 GUS THOMASSON RD, DALLAS, TX 75228-3017
(469) 399-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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