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General NPI Number Information
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NPI Number | 1053184259
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Entity Type | Organization
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Legal Business Name | O&M FAMILY WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 3224 I 30 STE 137
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City | MESQUITE
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State | TX
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Zip | 75150-2675
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Country | US
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Telephone | 239-465-2365
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Fax |
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Provider Business Mailing Address
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Address Line | 3224 I 30 STE 137
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City | MESQUITE
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State | TX
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Zip | 75150-2675
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Country | US
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Telephone | 239-465-2365
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Fax |
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Authorized Official
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Title or Position | OWNING PARTNER
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Name | OSLEIDY FERNANDEZ
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Credential | NP
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Telephone | 239-465-2365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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