MEDICARE: NU LIFE WELLNESS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QR0800X	Recovery Care Clinic/Center
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1437972858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NU LIFE WELLNESS, LLC

Provider Business Mailing Address
First Line	:	1434 OXBOW DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-4006
Country	:	US
Telephone Number	:	214-477-5594
Fax Number	:

Provider Business Practice Location Address
First Line	:	1434 OXBOW DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-4006
Country	:	US
Telephone Number	:	214-477-5594
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GLORIA TABRON
Credential	:
Telephone Number	:	214-477-5594

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/06/2024

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Directions to “NU LIFE WELLNESS, LLC ” Practice Location

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