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NPI Code Detail

MEDICARE: MEDLINK CLINICAL GROUP LLC

MEDICARE: MEDLINK CLINICAL GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1962337774
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDLINK CLINICAL GROUP LLC
Provider Business Mailing Address
First Line : 5900 BALCONES DR STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4298
Country : US
Telephone Number : 386-449-9745
Fax Number :
Provider Business Practice Location Address
First Line : 5900 BALCONES DR STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4298
Country : US
Telephone Number : 386-449-9745
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DAPHNEE DORVAL
Credential :
Telephone Number : 315-547-0502
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “MEDLINK CLINICAL GROUP LLC ” Practice Location

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