MEDICARE: SEED OF HOPE MEDICAL & WELLNESS 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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1558237099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEED OF HOPE MEDICAL & WELLNESS PLLC

Provider Business Mailing Address
First Line	:	539 W COMMERCE ST STE 2389
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:	469-724-4417
Fax Number	:

Provider Business Practice Location Address
First Line	:	5229 E LANCASTER AVE STE A
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-6358
Country	:	US
Telephone Number	:	469-724-4417
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATONYA THOMPSON
Credential	:
Telephone Number	:	469-724-4417

Provider Enumeration Date	:	10/13/2025
Last Update Date	:	10/13/2025

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