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NPI Code Detail

MEDICARE: LUXE WELLNESS & IV HYDRATION, PLLC

MEDICARE: LUXE WELLNESS & IV HYDRATION, PLLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1275491706
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUXE WELLNESS & IV HYDRATION, PLLC
Provider Business Mailing Address
First Line : 600 W 6TH ST STE 400
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-2849
Country : US
Telephone Number : 214-516-7850
Fax Number : 817-260-0083
Provider Business Practice Location Address
First Line : 600 W 6TH ST STE 400
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-2849
Country : US
Telephone Number : 214-516-7850
Fax Number : 817-260-0083
Authorized Official
Title or Position : FAMILY NURSE PRACTITIONER/OWNER
Name : MARCQUISHA KEITA
Credential : FNP
Telephone Number : 336-398-0288
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “LUXE WELLNESS & IV HYDRATION, PLLC ” Practice Location

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