Healthcare Provider Details

I. General information

NPI: 1386587939
Provider Name (Legal Business Name): PEER 2 PEER WHOLE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W RANDOL MILL RD STE 101
ARLINGTON TX
76011-4612
US

IV. Provider business mailing address

110 W RANDOL MILL RD STE 101
ARLINGTON TX
76011-4612
US

V. Phone/Fax

Practice location:
  • Phone: 469-755-2206
  • Fax:
Mailing address:
  • Phone: 469-755-2206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: JACK BROWN
Title or Position: EX DIR
Credential: MHPS/RSPS
Phone: 469-755-2206