MEDICARE: LIFELINE URGENT CARE 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
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1790631828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFELINE URGENT CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 739032
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-9032
Country	:	US
Telephone Number	:	281-771-1144
Fax Number	:	281-771-1146

Provider Business Practice Location Address
First Line	:	3414 MILTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-1338
Country	:	US
Telephone Number	:	281-771-1144
Fax Number	:	281-771-1146

Authorized Official
Title or Position	:	OWNER
Name	:	RAVI KUMAR KALIDINDI
Credential	:	MD
Telephone Number	:	412-513-6057

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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