DOORSTEP PROCARE MANAGEMENT LLC
Complete NPI Record 1275996860
General Practice in Mesquite, TX

NPI Status: Active since March 31, 2016

Contact Information

2944 MOTLEY DR STE 401
MESQUITE, TX
ZIP 75150
Phone: (972) 289-2273
Fax: (972) 439-1776

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Complete NPI Dataset

This page represents the complete record for NPI 1275996860. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1275996860
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 12035 SHILOH RD STE 310
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Business Mailing Address City Name: DALLAS
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: TX
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Postal Code: 752281507
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Telephone Number: 9722892273
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9722851396
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 2944 MOTLEY DR STE 401
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MESQUITE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address State Name: TX
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 751503464
The State code in the location of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9722892273
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9724391776
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 3/31/2016
The fax number associated with the location address of the provider being identified.
Last Update Date: 2/1/2023
The date that a record was last updated or changed.
Authorized Official Last Name: MENDIOLA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JESSIE
The first name of the authorized official.
Authorized Official Middle Name: GARZON
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Authorized Official Title or Position: MANAGING MEMBER
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Authorized Official Telephone Number: 4694384493
Healthcare Provider Taxonomy Code 1: 208D00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 3633174
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: TX
Is Organization Subpart: N
Authorized Official Name Prefix Text: MR.
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 2/1/2023