CLEANSLATE MEDICAL GROUP OF TEXAS PLLC – NPI #1487192522
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

CLEANSLATE MEDICAL GROUP OF TEXAS PLLC is a provider located in ARLINGTON, TX. NPPES has assigned the NPI number 1487192522 to CLEANSLATE MEDICAL GROUP OF TEXAS PLLC on February 09, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RA0401X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 3 years ago on Mar 23, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CLEANSLATE MEDICAL GROUP OF TEXAS PLLC below.

NPI Profile for
CLEANSLATE MEDICAL GROUP OF TEXAS PLLC

NPI Number
1487192522
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CLEANSLATE MEDICAL GROUP OF TEXAS PLLC
Primary location
2912 KRAFT ST STE 30
ARLINGTON, TX 76010-5410
Phone: (413) 584-2173 Fax:
Mailing address
8 CADILLAC DR STE 180
BRENTWOOD, TN 37027-5393
Phone: (154) 250-0220 Fax:
Organization Subpart
No
Authorized Official
JESSICA AMICK
DIRECTOR
Phone: (727) 798-8160
Updated
Certification Date
Mar 23, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.