| Wholesome Clinic, Llc | |
|
4888 Dexter Dr Ste 300b Plano TX 75093-5565 | |
| (972) 905-9435 | |
| Not Available |
| Full Name | Wholesome Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4888 Dexter Dr Ste 300b, Plano, Texas |
| Authorized Official Name and Position | Stephanie Uchenna (NP/DIRECTOR) |
| Authorized Official Contact | 9729059534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wholesome Clinic, Llc 4888 Dexter Dr Ste 300b Plano TX 75093-5565 Ph: (972) 905-9435 | Wholesome Clinic, Llc 4888 Dexter Dr Ste 300b Plano TX 75093-5565 Ph: (972) 905-9435 |
| NPI Number | 1285329128 |
|---|---|
| Provider Enumeration Date | 04/06/2023 |
| Last Update Date | 09/04/2023 |
| Certification Date | 09/04/2023 |
| Medicare PECOS PAC ID | 4789039421 |
|---|---|
| Medicare Enrollment ID | O20231016001717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285329128 | NPI | - | NPPES |
| Provider Name | Uchenna Stephanie Ukoha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134580814 PECOS PAC ID: 4789976242 Enrollment ID: I20160705000095 |
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