| Neely Total Health & Wellness Llc | |
|
1510 N.hampton Rd. Suite 220 Desoto TX 75115-8301 | |
| (972) 707-0113 | |
| (972) 249-2057 |
| Full Name | Neely Total Health & Wellness Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1510 N.hampton Rd., Desoto, Texas |
| Authorized Official Name and Position | Charnita Patrice Neely (OWNER) |
| Authorized Official Contact | 9722175620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neely Total Health & Wellness Llc 1510 N. Hampton Rd. Suite 220 Desoto TX 75115-8301 Ph: (972) 707-0113 | Neely Total Health & Wellness Llc 1510 N.hampton Rd. Suite 220 Desoto TX 75115-8301 Ph: (972) 707-0113 |
| NPI Number | 1861149593 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 06/15/2022 |
| Medicare PECOS PAC ID | 8426430992 |
|---|---|
| Medicare Enrollment ID | O20220729002430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861149593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Charnita P Neely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508243841 PECOS PAC ID: 2668787391 Enrollment ID: I20150810002742 |
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