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General NPI Number Information
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NPI Number | 1821466764
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Entity Type | Organization
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Legal Business Name | LWHP FAMILY WELLNESS GROUP PLLC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 02/08/2026
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Provider Practice Location Address
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Address Line | 6331 PROSPECT AVE
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City | DALLAS
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State | TX
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Zip | 75214-3938
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Country | US
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Telephone | 214-535-8109
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Fax | 214-821-6332
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Provider Business Mailing Address
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Address Line | 6331 PROSPECT AVE
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City | DALLAS
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State | TX
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Zip | 75214-3938
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Country | US
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Telephone | 214-535-8109
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Fax | 214-821-6331
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Authorized Official
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Title or Position | OWNER
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Name | KENDRA MARKS BREITHAUPT
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Credential | FNP-C
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Telephone | 214-535-8109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 595938
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License Number State | TX
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