Healthcare Provider Details

I. General information

NPI: 1285329128
Provider Name (Legal Business Name): WHOLESOME CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7978 PRESTON RD STE 804
FRISCO TX
75034-5607
US

IV. Provider business mailing address

7978 PRESTON RD STE 804
FRISCO TX
75034-5607
US

V. Phone/Fax

Practice location:
  • Phone: 972-905-9435
  • Fax: 972-905-9489
Mailing address:
  • Phone: 972-905-9435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE UCHENNA
Title or Position: NP/DIRECTOR
Credential: NP
Phone: 972-905-9534