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General NPI Number Information
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NPI Number | 1447827324
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Entity Type | Organization
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Legal Business Name | QUANTUM-PD FUNCTIONAL HEALTH AND WHOLENESS CLINIC PLLC
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 9555 LEBANON RD STE 1003
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City | FRISCO
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State | TX
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Zip | 75035-6088
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Country | US
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Telephone | 214-872-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 9555 LEBANON RD STE 1003
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City | FRISCO
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State | TX
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Zip | 75035-6088
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Country | US
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Telephone | 214-872-1232
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Fax | 214-872-1237
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Authorized Official
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Title or Position | OWNER
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Name | MRS. OYETOKUNBO LEMORU
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Credential | FNP
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Telephone | 214-872-1232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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