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General NPI Number Information
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NPI Number | 1548125057
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Entity Type | Organization
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Legal Business Name | VERSAILLES HEALTH AND WELLNESS CLINIC, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 750 E INTERSTATE 30 STE 175
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City | ROCKWALL
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State | TX
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Zip | 75087-5525
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Country | US
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Telephone | 469-517-3144
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Fax | 866-519-0550
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Provider Business Mailing Address
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Address Line | 750 E INTERSTATE 30 STE 175
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City | ROCKWALL
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State | TX
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Zip | 75087-5525
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Country | US
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Telephone | 469-517-3144
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Fax | 866-519-0550
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DORCAS LOMO
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Credential | MD
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Telephone | 469-517-3144
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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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