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General NPI Number Information
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NPI Number | 1609765726
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Entity Type | Organization
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Legal Business Name | LIVE WELLNESS SURGICAL, PLLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 4333 N JOSEY LN STE 101
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City | CARROLLTON
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State | TX
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Zip | 75010-4620
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Country | US
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Telephone | 972-850-6122
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Fax |
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Provider Business Mailing Address
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Address Line | 8700 STONEBROOK PKWY UNIT 958
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City | FRISCO
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State | TX
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Zip | 75034-5804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. KANENECHUKWU UBESIE
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Credential | MD, MBA, FACS
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Telephone | 972-850-6122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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