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General NPI Number Information
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NPI Number | 1427671981
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Entity Type | Organization
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Legal Business Name | STAYING HEALTHY WELLNESS LLC
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 4700 DEXTER DR STE 300B
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City | PLANO
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State | TX
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Zip | 75093-5294
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Country | US
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Telephone | 877-846-5944
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Fax |
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Provider Business Mailing Address
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Address Line | 4505 MAHOGANY LN
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City | COPPER CANYON
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State | TX
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Zip | 75077-8546
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Country | US
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Telephone | 469-569-7162
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ARTHUR STANLEY DAWSON
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Credential |
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Telephone | 469-569-7162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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