PARKSIDE FAMILY CLINIC - NPI 1659770030 - Clinic/Center in Cuero, TX

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

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About Parkside Family Clinic NPPES

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

PARKSIDE FAMILY CLINIC (NPI 1659770030) is a healthcare organization registered as a rural health in Cuero, Texas and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through August 10, 2026 and lists Lynn Falcone, Administrator/ceo, as its authorized official.

NPPES Registry Identity

NPI1659770030

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameDEWITT MEDICAL DISTRICT

Location Address1109 E BROADWAY STCuero, TX 77954-2108

Mailing Address1109 E Broadway StCuero, TX 77954-2108 · (361) 275-2800 · Fax (361) 275-8791

Phone(361) 275-2800

Fax(361) 275-8791

Organization SubpartNo

Authorized OfficialLynn FalconeAdministrator/ceo · (361) 275-6191

Enumeration DateAugust 21, 2014

Last NPPES UpdateAugust 18, 20223 updates tracked since enumeration

NPPES CertifiedAugust 18, 2022

✔ NPI 1659770030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedFamily MedicineTaxonomy 207Q00000X

1109 E BROADWAY ST, Cuero, TX 77954

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Other Names 1

Doing Business AsParkside Family Clinic

Other Identifiers 3

Medicaid344242801TX

Medicaid350897001TX

Medicaid350897002TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 45D1048204
Facility Type: Physician Office
Certificate Effective Date: August 11, 2024
Certificate Expiration Date: August 10, 2026
Laboratory Director: SHERYL MILLS
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Parkside Family Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.