Provider Demographics
NPI:1790427441
Name:CLINICA MEDICA SALVE PLLC
Entity Type:Organization
Organization Name:CLINICA MEDICA SALVE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ESPIRIDION
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-549-2273
Mailing Address - Street 1:217 W MAIN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5648
Mailing Address - Country:US
Mailing Address - Phone:214-549-2273
Mailing Address - Fax:972-329-7005
Practice Address - Street 1:217 W MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5648
Practice Address - Country:US
Practice Address - Phone:214-235-0607
Practice Address - Fax:972-329-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty