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General NPI Number Information
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NPI Number | 1902485618
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Entity Type | Organization
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Legal Business Name | MIND-BODY HEALTH COACHING OF NORTH TEXAS
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 10455 N CENTRAL EXPY STE 113
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City | DALLAS
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State | TX
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Zip | 75231-2229
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Country | US
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Telephone | 214-505-8821
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Fax |
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Provider Business Mailing Address
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Address Line | 2565 HISTORY LN
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City | PLANO
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State | TX
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Zip | 75075-0011
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Country | US
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Telephone | 214-505-8821
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Fax |
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Authorized Official
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Title or Position | OWNER, MEDICAL DIRECTOR
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Name | DOMINIQUE ALBERT KASINDI
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Credential | MD
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Telephone | 469-931-4334
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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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