MEDICARE: TREE OF LIFE BIRTH COUNSELING AND WELLNESS CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QB0400X	Birthing Clinic/Center
2	261QA1903X	Ambulatory Surgical Clinic/Center
3	176B00000X	Midwife

General Provider Information

NPI Number	:	1063216281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREE OF LIFE BIRTH COUNSELING AND WELLNESS CENTER PLLC

Provider Business Mailing Address
First Line	:	1705 ELSIE FAYE HEGGINS DRIVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75215
Country	:	US
Telephone Number	:	214-912-2614
Fax Number	:	214-912-2614

Provider Business Practice Location Address
First Line	:	1705 ELSIE FAY HEGGINS ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75215
Country	:	US
Telephone Number	:	214-912-2614
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PROF. CHERYL EDINBYRD
Credential	:	PHD
Telephone Number	:	214-912-2614

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	12/11/2025

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