MIRAE CLINIC (NPI# 1164668588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164668588 |
| Entity Type | Organization |
| Organization Name | MIRAE CLINIC |
| Practice Address |
2035 Royal Ln Ste 280 Dallas TX 75229-3268 |
| Practice Telephone | 2143526677 |
| Practice Fax Number | 8776434072 |
| Mailing Telephone | 2143526677 |
| Mailing Fax Number | 8776434072 |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |
| Authorized Official Name | DR. DAVID KOH (PRESIDENT) |
| Authorized Official Telephone | 2143526677 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 8306 | TX | Ambulatory Health Care Facilities |
| Street Address |
2035 ROYAL LN STE 280 |
| City | DALLAS |
| State | TX |
| Zip Code | 75229-3268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454602 | Obioma Anyogu | Nurse Practitioner | 1521 East Royal Lane, Apt 3208, Farmersbrabch, TX 75229 | 2020-03-30 |
| 1700399003 | Margaret F Wangsgaard | Dietitian, Registered | 3262 Dothan Ln, Dallas, TX 75229 | 2017-11-08 |
| 1710333075 | Egma LLC | Eyewear Supplier (Equipment, not the service) | 11234 Goodnight Lane, Dallas, TX 75229 | 2016-05-05 |
| 1770955924 | Sarah Loucks | Occupational Therapist | 3265 Dartmoor Ct, Dallas, TX 75229 | 2015-10-28 |
| 1750711222 | Maureen Elizabeth Veysset | Nurse Practitioner | 3207 Rotan Ln, Dallas, TX 75229 | 2013-11-20 |
| 1811248826 | Virginia F. Velez | Counselor | 2636 Walnut Hill Ln., Suite #330, Dallas, TX 75229 | 2012-10-01 |
| 1306128210 | Marshal Neil Decker | Technician, Other | 11034 Shady Trail, Suite 112, Dallas, TX 75229 | 2011-09-16 |
| 1275785883 | Rc Chiropractic and Sports Injury Care | Chiropractor | 11029 Shady Trail, 113, Dallas, TX 75229 | 2008-10-14 |
| 1639335672 | Young An Church | Durable Medical Equipment & Medical Supplies | 11445 Emerald St, Dallas, TX 75229 | 2008-07-30 |
| 1336345347 | Sung Ae Lee | Dentist | 2560 Royal Lane, #222, Dallas, TX 75229 | 2007-06-26 |
| Find all providers in zip 75229 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982214375 | Hippomed Wellness Clinics Limited Company | Clinic/Center | 5930 Lbj Fwy Ste 380, Dallas, TX 75240-6370 | 2020-07-31 |
| 1417566415 | Bonnieview-overton Medical Clinic | Clinic/Center | 3507 Bonnie View Rd, Dallas, TX 75216-4704 | 2020-07-26 |
| 1679123632 | Equilyst LLC. | Clinic/Center | 2909 Canton St Ste C, Dallas, TX 75226-3508 | 2019-09-12 |
| 1962977355 | Resolves Healthcare Services, LLC | Clinic/Center | 5151 Belt Line Rd Ste 715, Dallas, TX 75254-7547 | 2018-10-11 |
| 1376067793 | William Parker Highland Park | Clinic/Center | 4442 Lovers Lane, Dallas, TX 75225-6923 | 2017-07-27 |
| 1851724918 | Joey D. Tran, Od Pllc | Clinic/Center | 5334 Ross Ave Ste 100, Dallas, TX 75206-7402 | 2013-08-13 |
| 1972856631 | Bridge Medical Group LLC | Clinic/Center | 4303 N Central Expy, Dallas, TX 75205-5597 | 2012-10-18 |
| 1609127000 | Lyndsay M Posey | Clinic/Center | 289 E Ellendale Ave Ste 601, Dallas, OR 97338-1570 | 2012-09-25 |
| 1780969584 | Questcare | Clinic/Center | 12221 Merit Dr Ste 1620, Dallas, TX 75251-2208 | 2011-10-13 |
| 1265664874 | Glamour Technology and Wellness | Clinic/Center | 206 S Zang Blvd, Dallas, TX 75208-4519 | 2009-08-14 |
| Find all providers in DALLAS | ||||
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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.