Provider Demographics
NPI:1659018604
Name:4L-A CLINIC AND CONSULTANTS INC
Entity Type:Organization
Organization Name:4L-A CLINIC AND CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LILIAN MELVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MLP
Authorized Official - Phone:832-922-3201
Mailing Address - Street 1:1000 SUNRISE CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-8250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2502 S BELT LINE RD STE 400B
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-5345
Practice Address - Country:US
Practice Address - Phone:832-922-3201
Practice Address - Fax:469-647-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty