MEDICARE: UNIQUE PASSIONATE HEALTHCARE PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	343800000X	Secured Medical Transport (VAN)
3	343900000X	Non-emergency Medical Transport (VAN)
4	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1457094690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE PASSIONATE HEALTHCARE PLLC

Provider Business Mailing Address
First Line	:	539 W COMMERCE ST # 4316
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 E RANDOL MILL RD STE 700
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-1410
Country	:	US
Telephone Number	:	469-320-1947
Fax Number	:	469-282-7088

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	MS. CHRISTA ANN BOLDEN
Credential	:	FNP-BC
Telephone Number	:	469-320-1947

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	09/10/2024

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