| Lifeline Family Health & Wellness, Pllc | |
|
9330 Poppy Dr Ste 500 Dallas TX 75218-4612 | |
| (469) 384-7781 | |
| (469) 277-3000 |
| Full Name | Lifeline Family Health & Wellness, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9330 Poppy Dr Ste 500, Dallas, Texas |
| Authorized Official Name and Position | Shunkeetha Latrice Totsch (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 4693847781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Family Health & Wellness, Pllc 5900 Balcones Dr Ste 100 Austin TX 78731-4298 Ph: (214) 641-0218 | Lifeline Family Health & Wellness, Pllc 9330 Poppy Dr Ste 500 Dallas TX 75218-4612 Ph: (469) 384-7781 |
| NPI Number | 1073211959 |
|---|---|
| Provider Enumeration Date | 02/20/2023 |
| Last Update Date | 04/06/2024 |
| Medicare PECOS PAC ID | 5890158109 |
|---|---|
| Medicare Enrollment ID | O20230901002090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073211959 | NPI | - | NPPES |
| 1154734010 | Other | TX | OWNER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Shunkeetha Latrice Totsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154734010 PECOS PAC ID: 7012214646 Enrollment ID: I20230901002248 |
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