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General NPI Number Information
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NPI Number | 1477073807
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Entity Type | Organization
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Legal Business Name | PARK CITIES WELLNESS PLUS LLC
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6211 W NORTHWEST HWY STE C255
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City | DALLAS
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State | TX
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Zip | 75225-3498
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Country | US
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Telephone | 469-620-0445
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Fax | 469-620-0446
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Provider Business Mailing Address
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Address Line | 6211 W NORTHWEST HWY STE C255
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City | DALLAS
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State | TX
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Zip | 75225-3498
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Country | US
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Telephone | 469-620-0445
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Fax | 469-620-0446
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Authorized Official
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Title or Position | OWNER
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Name | CELIA DOLINTA
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Credential |
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Telephone | 469-620-0445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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