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General NPI Number Information
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NPI Number | 1457725277
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Entity Type | Organization
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Legal Business Name | MEN'S WELLNESS AND TESTOSTERONE CENTER, LLC
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 945 W STACY RD STE 120
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City | ALLEN
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State | TX
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Zip | 75013-5077
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Country | US
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Telephone | 214-212-1538
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Fax |
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Provider Business Mailing Address
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Address Line | 945 W STACY RD STE 120
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City | ALLEN
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State | TX
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Zip | 75013-5077
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Country | US
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Telephone | 214-212-1538
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. GULAM M WAHEED
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Credential | D.O.
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Telephone | 214-212-1538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | N0923
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License Number State | TX
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