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DESTINATION HEALTH
NPI 1346646528
Family Medicine - Adult Medicine in Southlake, TX

Active since November 14, 2014CLIA 45D1049267 · Waiver
900 E SOUTHLAKE BLVD, SUITE 200, SOUTHLAKE, TX 76092(817) 310-6050(817) 310-6051 Get Directions Write a Review

NPPES record last updated: November 14, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Destination Health NPPES

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

DESTINATION HEALTH (NPI 1346646528) is a healthcare organization registered as an adult medicine in Southlake, Texas and active in the NPI registry since November 2014. The organization holds a CLIA Waiver certificate valid through December 29, 2027 and lists Julie K Timmons, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1346646528
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameDESTINATION HEALTH
Location Address900 E SOUTHLAKE BLVD, SUITE 200Southlake, TX 76092-6375
Mailing Address900 E Southlake Blvd, Suite 200Southlake, TX 76092-6375 · (817) 310-6050 · Fax (817) 310-6051
Phone(817) 310-6050
Fax(817) 310-6051
Organization SubpartNo
Authorized OfficialJulie K TimmonsOperations Manager · (817) 310-6050
Enumeration DateNovember 14, 2014
✔ NPI 1346646528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in TX · H6268
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
900 E SOUTHLAKE BLVD, Southlake, TX 76092
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Other Identifiers 1

Medicare UPINE45979TX

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 45D1049267

Destination Health · Southlake, TX
Active · expires Dec 29, 2027
CLIA Number45D1049267
Laboratory TypePhysician Office
Certificate Effective DateDecember 30, 2025
Certificate Expiration DateDecember 29, 2027
Laboratory DirectorCarl Ducharme
Laboratory Phone(817) 310-6050
Laboratory LocationDestination Health900 E Southlake Blvd Suite 200, Southlake, TX 76092
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

CAITLIN ELIZABETH PEDIGO RNFA
Registered Nurse (Registered Nurse First Assistant)
900 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 442-8900
DR. MADIHA ELHAM HUQ DO
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770
MARK E MASON MD
Oral & Maxillofacial Surgery
900 E SOUTHLAKE BLVD, STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 442-8900
SOUTHLAKE PLASTIC SURGERY
Plastic Surgery
900 E SOUTHLAKE BLVD, STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 442-8900
DR. ROBIN ANNETTE HALL D.O.
Family Medicine (Adult Medicine)
900 E SOUTHLAKE BLVD, SUITE 200
SOUTHLAKE, TX 76092
Tarrant County (817) 310-6050
ALIREZA ALLEN SHAKOURI MD
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD, STE 300
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770
TEXAS REGIONAL ASTHMA & ALLERGY CENTER
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD, STE 300
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770
DR. RENE ALBERT LEON M.D.
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD, STE 300
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770

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 Destination Health's NPI number?

The NPI number for Destination Health is 1346646528. It was assigned to this organization in the NPPES registry on November 14, 2014.

Where is Destination Health located?

Destination Health is located at 900 E Southlake Blvd Suite 200, Southlake, TX 76092. The listed phone number is (817) 310-6050.

What is Destination Health's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Does Destination Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1049267) is associated with this NPI, valid through December 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Destination Health was last updated on November 14, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.