SUPREME WISDOM FAMILY HEALTH CLINIC INC
NPI 1801176474
Nurse Practitioner - Family in Grand Prairie, TX

Q: What is Supreme Wisdom Family Health Clinic Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since August 26, 2011

455 GOTLAND DR, GRAND PRAIRIE, TX 75052(469) 831-3149 Get Directions Write a Review

NPPES record last updated: September 15, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Supreme Wisdom Family Health Clinic Inc NPPES

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

SUPREME WISDOM FAMILY HEALTH CLINIC INC (NPI 1801176474) is a healthcare organization registered as a family in Grand Prairie, Texas and active in the NPI registry since August 2011. The organization lists Khaliliah Ali, President, as its authorized official.

NPPES Registry Identity

NPI1801176474

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameSUPREME WISDOM FAMILY HEALTH CLINIC INC

Location Address455 GOTLAND DRGrand Prairie, TX 75052-2570

Mailing Address455 Gotland DrGrand Prairie, TX 75052-2570 · (469) 831-3149

Phone(469) 831-3149

Organization SubpartNo

Authorized OfficialKhaliliah AliPresident · (469) 835-3449

Enumeration DateAugust 26, 2011

Last NPPES UpdateSeptember 15, 2011

✔ NPI 1801176474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TX · 682811

455 GOTLAND DR, Grand Prairie, TX 75052

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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

Other Providers at the Same Location NPPES

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

KHALILLAH S ALI NP

Nurse Practitioner (Family)

455 GOTLAND DR
GRAND PRAIRIE, TX 75052

Dallas County (469) 831-3149

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 Supreme Wisdom Family Health Clinic Inc's NPI number?

The NPI number for Supreme Wisdom Family Health Clinic Inc is 1801176474. It was assigned to this organization in the NPPES registry on August 26, 2011.

Where is Supreme Wisdom Family Health Clinic Inc located?

Supreme Wisdom Family Health Clinic Inc is located at 455 Gotland Dr, Grand Prairie, TX 75052. The listed phone number is (469) 831-3149.

What is Supreme Wisdom Family Health Clinic Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Supreme Wisdom Family Health Clinic Inc was last updated on September 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.