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General NPI Number Information
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NPI Number | 1609639178
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Entity Type | Organization
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Legal Business Name | ELITE TOTAL WELLNESS PLLC
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1402 S CUSTER RD STE 704
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City | MCKINNEY
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State | TX
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Zip | 75072-1453
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Country | US
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Telephone | 469-915-5069
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Fax | 469-915-5069
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Provider Business Mailing Address
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Address Line | 1402 S CUSTER RD STE 704
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City | MCKINNEY
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State | TX
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Zip | 75072-1453
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Country | US
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Telephone | 469-915-5069
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Fax | 469-915-5069
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN WILLIAMS
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Credential | NP
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Telephone | 214-842-9830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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