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General NPI Number Information
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NPI Number | 1124744370
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Entity Type | Organization
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Legal Business Name | PREMIER CHOICE MEDICAL AND WELLNESS PLLC
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 2727 BOLTON BOONE DR STE 110
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City | DESOTO
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State | TX
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Zip | 75115-2019
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Country | US
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Telephone | 469-248-0890
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Fax | 817-549-3579
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Provider Business Mailing Address
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Address Line | 2727 BOLTON BOONE DR STE 110
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City | DESOTO
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State | TX
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Zip | 75115-2019
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Country | US
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Telephone | 469-248-0890
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Fax | 817-549-3579
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Authorized Official
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Title or Position | OWNER
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Name | SHELIA DENISE JONES
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Credential | FNP-BC
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Telephone | 214-241-9782
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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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