CLEANSLATE MEDICAL GROUP OF TEXAS PLLC (NPI# 1487192522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487192522 |
| Entity Type | Organization |
| Organization Name | CLEANSLATE MEDICAL GROUP OF TEXAS PLLC |
| Practice Address |
2912 Kraft St Ste 30 Arlington TX 76010-5410 |
| Mailing Address |
15 Century Blvd Ste 307 Nashville TN 37214-3692 |
| Practice Telephone | 4135842173 |
| Mailing Telephone | 6154250220 |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | ROBERT HUTCHISON (CFO) |
| Authorized Official Telephone | 6154250220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2912 KRAFT ST STE 30 |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76010-5410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538679147 | Evbu Evely Osunde | Nurse Practitioner | 1115 E Arkansas Lane, Suite B, Arlington, TX 76010 | 2017-10-10 |
| 1710429725 | Faith Home Care LLC | Home Health | 201 E Abram Ste #120, Arlington, TX 76010 | 2016-11-08 |
| 1487017687 | Vietcare Home Health Inc | Technician | 124 W Pioneer Pkwy # 160, Arlington, TX 76010 | 2016-04-04 |
| 1003278615 | Donna Green | Nurse Practitioner | 615 East Abrams, Arlington, TX 76010 | 2016-03-23 |
| 1568701241 | Antonio P. Serrano, M.d., P.a. | Family Medicine | 100 W. Pioneer Pkwy, Suite 111, Arlington, TX 76010 | 2013-01-31 |
| 1770860173 | Spruce Dental | Dentist | 939 E. Park Row Dr, Arlington, TX 76010 | 2011-11-14 |
| 1730488461 | Truecare Dfw, Inc | Home Health | 1120 E Pioneer Pkwy Ste 102, Arlington, TX 76010 | 2011-03-21 |
| 1669776464 | Nisha Liz John | Dentist | 1900 East Pioneer Parkway, Arlington, TX 76010 | 2011-01-07 |
| 1649500398 | Elaine P Nguyen | Registered Nurse | 1816 Jocyle St, Arlington, TX 76010 | 2009-12-31 |
| 1285801589 | North Texas Addiction Counseling & Education, Inc. | Clinic/Center | 124 W Pioneer Pkwy Ste 120, Arlington, TX 76010 | 2008-05-15 |
| Find all providers in zip 76010 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427508027 | Bela Roth | Internal Medicine | 2427 Thorndon Park Ct, League City, TX 77573-5563 | 2016-10-06 |
| 1639450182 | Jeremias M. Abueme,md,pa | Internal Medicine | 5282 Medical Dr Ste 130, San Antonio, TX 78229-6023 | 2011-08-29 |
| 1538165162 | Migdalia Molina | Internal Medicine | 730 N Main, Ste 515, San Antonio, TX 78205-1116 | 2005-06-28 |
| 1588173967 | Woodlands Addiction Medicine Group | Internal Medicine | 2610 Technology Forest Blvd, The Woodlands, TX 77381-3904 | 2017-09-28 |
| 1013456375 | Hs Physician Services of Texas PC | Internal Medicine | 3800 County Road 444, Princeton, TX 75407-4432 | 2017-02-20 |
| 1457712291 | Talvah LLC | Internal Medicine | 8201 Ohio Dr, 112, Plano, TX 75024-2357 | 2016-03-07 |
| 1366626517 | Kerrville Medical Services, Pa | Internal Medicine | 145 La Hacienda Way, La Hacienda Treatment Center, Hunt, TX 78024 | 2007-12-24 |
Please comment or provide details below to improve the information on CLEANSLATE MEDICAL GROUP OF TEXAS PLLC.
| 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.