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DEKALB PHYSICIANS CLINIC LLC
NPI 1265565691
Family Medicine in De Kalb, TX

Active since March 14, 2007CLIA 45D1044009 · Waiver
1250 S RUNNELS ST, DE KALB, TX 75559(903) 667-2273(903) 667-7597 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dekalb Physicians Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEKALB PHYSICIANS CLINIC LLC (NPI 1265565691) is a healthcare organization registered as a family medicine in De Kalb, Texas and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through September 23, 2026 and lists Kyle Wayne Groom, Owner - Physician, as its authorized official.

NPPES Registry Identity

NPI1265565691
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDEKALB PHYSICIANS CLINIC LLC
Location Address1250 S RUNNELS STDe Kalb, TX 75559-2317
Mailing Address216 N Centre StDe Kalb, TX 75559-1406 · (903) 667-2273 · Fax (903) 667-7597
Phone(903) 667-2273
Fax(903) 667-7597
Organization SubpartNo
Authorized OfficialKyle Wayne GroomOwner - Physician · (903) 667-2273
Enumeration DateMarch 14, 2007
Last NPPES UpdateJanuary 30, 2023
NPPES CertifiedJanuary 30, 2023
✔ NPI 1265565691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · L5749
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1250 S RUNNELS ST, De Kalb, TX 75559
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Other Identifiers 3

Other8S7090TX · Blue Cross Blue Shield
Medicaid177214701TX
Other8P152AR · Ark Blue Cross Blue Shiel

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1044009

Dekalb Physicians Clinic · De Kalb, TX
Active · expires Sep 23, 2026
CLIA Number45D1044009
Laboratory TypePhysician Office
Certificate Effective DateSeptember 24, 2024
Certificate Expiration DateSeptember 23, 2026
Laboratory DirectorKyle W. Groom
Laboratory Phone(903) 667-2273
Laboratory LocationDekalb Physicians Clinic216 Centre St, De Kalb, TX 75559
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INGRAM HEALTH CONSULTING
Clinic/Center (Primary Care)
1250 S RUNNELS ST
DE KALB, TX 75559
Bowie County (903) 280-8173
JANET MARLENE MORELAND PA
Physician Assistant
1250 S RUNNELS ST
DE KALB, TX 75559
Bowie County (903) 667-2273

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dekalb Physicians Clinic LLC's NPI number?

The NPI number for Dekalb Physicians Clinic LLC is 1265565691. It was assigned to this organization in the NPPES registry on March 14, 2007.

Where is Dekalb Physicians Clinic LLC located?

Dekalb Physicians Clinic LLC is located at 1250 S Runnels St, De Kalb, TX 75559. The listed phone number is (903) 667-2273.

What is Dekalb Physicians Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Dekalb Physicians Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1044009) is associated with this NPI, valid through September 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dekalb Physicians Clinic LLC was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.