Healthcare Provider Details

I. General information

NPI: 1538543798
Provider Name (Legal Business Name): KARLA LLUBERES GORDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 W NORTHWEST HWY STE 170
DALLAS TX
75220
US

IV. Provider business mailing address

2750 W NORTHWEST HWY STE 170
DALLAS TX
75220-4783
US

V. Phone/Fax

Practice location:
  • Phone: 214-654-0007
  • Fax: 214-654-9272
Mailing address:
  • Phone: 214-654-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR6229
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: