Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

South Polk Medical Clinic LLC

Organization Nurse Practitioner · NPI 1043351760

South Polk Medical Clinic LLC provides Nurse Practitioner services in Dallas, Texas. Licensed in Texas. Registered with an NPI since 2007.

Licensed in
TX
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3436 S Polk St
Dallas, TX 75224-3804 Not confirmed with CMS for 15 years — call before visiting
Phone: (214) 372-1051
Fax: (214) 372-9201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 578285 (TX)

Record details

NPI number1043351760
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official El Greco Roberts — Vice President Of Business Affairs · (214) 372-1051
NPI enumeratedFebruary 8, 2007
Last updated in NPPESJuly 26, 2011
Mailing address3436 S Polk St, Dallas, TX 75224-3804

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