Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clinic 21 of Tarrant County, PLLC

Organization Emergency Medicine Physician · NPI 1871986109

Clinic 21 of Tarrant County, PLLC is an Emergency Medicine Physician in Southlake, Texas. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

431 E State Highway 114 Ste 120
Southlake, TX 76092-4407
Phone: (817) 251-3981
Fax: (817) 251-3245
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X

Record details

NPI number1871986109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Packo — President · (330) 493-4443
NPI enumeratedMarch 11, 2015
Last updated in NPPESNovember 16, 2015
Mailing address4535 Dressler Rd Nw, Canton, OH 44718-2545

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