Healthcare Provider Details
I. General information
NPI: 1689211971
Provider Name (Legal Business Name): TOTAL HEALTH AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2019
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6435 S FM 549 STE 201A
HEATH TX
75032-6220
US
IV. Provider business mailing address
5907 YACHT CLUB DR
ROCKWALL TX
75032-5749
US
V. Phone/Fax
- Phone: 214-455-2487
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERRY
A
HOOVER
Title or Position: OWNER
Credential: FNP
Phone: 214-455-2487