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NPI Code Detail

MEDICARE: LWHP FAMILY WELLNESS GROUP PLLC

MEDICARE: LWHP FAMILY WELLNESS GROUP 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 Practitioner595938TX

General Provider Information

NPI Number : 1821466764
Entity Type Code : Organization
Provider Name (Legal Business Name) : LWHP FAMILY WELLNESS GROUP PLLC
Provider Business Mailing Address
First Line : 6331 PROSPECT AVE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3938
Country : US
Telephone Number : 214-535-8109
Fax Number : 214-821-6331
Provider Business Practice Location Address
First Line : 6331 PROSPECT AVE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3938
Country : US
Telephone Number : 214-535-8109
Fax Number : 214-821-6332
Authorized Official
Title or Position : OWNER
Name : KENDRA MARKS BREITHAUPT
Credential : FNP-C
Telephone Number : 214-535-8109
Provider Enumeration Date : 09/09/2015
Last Update Date : 02/08/2026

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