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CLINICA GUADALUPE GRAND PLAZA,LLC
NPI 1316633043
Family Medicine in Fort Worth, TX

Active since April 14, 2023CLIA 45D1004164 · Waiver
4200 SOUTH FWY STE 15, FORT WORTH, TX 76115(469) 931-2538 Get Directions Write a Review

NPPES record last updated: April 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clinica Guadalupe Grand Plaza,llc NPPES

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

CLINICA GUADALUPE GRAND PLAZA,LLC (NPI 1316633043) is a healthcare organization registered as a family medicine in Fort Worth, Texas and active in the NPI registry since April 2023. The organization holds a CLIA Waiver certificate valid through September 19, 2026 and lists Cindy Olalde, Officer, as its authorized official.

NPPES Registry Identity

NPI1316633043
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCLINICA GUADALUPE GRAND PLAZA,LLC
Location Address4200 SOUTH FWY STE 15Fort Worth, TX 76115-1423
Mailing Address14951 Dallas Pkwy Ste 190Dallas, TX 75254-6894
Phone(469) 931-2538
Organization SubpartNo
Authorized OfficialCindy OlaldeOfficer · (214) 240-1506
Enumeration DateApril 14, 2023
NPPES CertifiedApril 14, 2023
✔ NPI 1316633043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
4200 SOUTH FWY STE 15, Fort Worth, TX 76115
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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 45D1004164

Clinica Guadalupe · Fort Worth, TX
Active · expires Sep 19, 2026
CLIA Number45D1004164
Laboratory TypePhysician Office
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorAlberto Flores
Laboratory Phone(817) 378-0777
Laboratory LocationClinica Guadalupe1220 N Main St Ste 100, Fort Worth, TX 76164
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Clinica Guadalupe Grand Plaza,llc's NPI number?

The NPI number for Clinica Guadalupe Grand Plaza,llc is 1316633043. It was assigned to this organization in the NPPES registry on April 14, 2023.

Where is Clinica Guadalupe Grand Plaza,llc located?

Clinica Guadalupe Grand Plaza,llc is located at 4200 South Fwy Ste 15, Fort Worth, TX 76115. The listed phone number is (469) 931-2538.

What is Clinica Guadalupe Grand Plaza,llc's specialty?

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

Does Clinica Guadalupe Grand Plaza,llc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1004164) is associated with this NPI, valid through September 19, 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 Clinica Guadalupe Grand Plaza,llc was last updated on April 14, 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.