Healthcare Provider Details

I. General information

NPI: 1588058440
Provider Name (Legal Business Name): NUPLEXA WELLNESS CENTERS OF AMERICA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N SAINT PAUL ST 200
DALLAS TX
75201-3114
US

IV. Provider business mailing address

2387 MIDWAY RD
CARROLLTON TX
75006-2521
US

V. Phone/Fax

Practice location:
  • Phone: 214-954-4357
  • Fax:
Mailing address:
  • Phone: 214-420-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number StateTX

VIII. Authorized Official

Name: DR. DENNIS BLACK
Title or Position: OWNER
Credential: N.D
Phone: 214-420-4020