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General NPI Number Information
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NPI Number | 1215816053
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Entity Type | Organization
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Legal Business Name | HEAL TECH MED LLC
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 2384 HIGHWAY 287 N STE 216
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City | MANSFIELD
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State | TX
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Zip | 76063-9207
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Country | US
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Telephone | 469-567-9974
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Fax | 817-415-6595
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Provider Business Mailing Address
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Address Line | 2384 HIGHWAY 287 N STE 216
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City | MANSFIELD
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State | TX
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Zip | 76063-9207
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Country | US
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Telephone | 469-567-9974
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Fax | 817-415-6595
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Authorized Official
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Title or Position | OWNER
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Name | PAIDAMOYO YVONNE WAGONEKA
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Credential |
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Telephone | 469-567-9974
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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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