Healthcare Provider Details

I. General information

NPI: 1548125057
Provider Name (Legal Business Name): VERSAILLES HEALTH AND WELLNESS CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E INTERSTATE 30 STE 175
ROCKWALL TX
75087-5525
US

IV. Provider business mailing address

750 E INTERSTATE 30 STE 175
ROCKWALL TX
75087-5525
US

V. Phone/Fax

Practice location:
  • Phone: 469-517-3144
  • Fax: 866-519-0550
Mailing address:
  • Phone: 469-517-3144
  • Fax: 866-519-0550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DORCAS LOMO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 469-517-3144