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RENOVAR WELLCARE PLLC NPI 1013407451


NPI Information

NPI: 1013407451
Provider Name: RENOVAR WELLCARE PLLC

Doing Business As: ESSENCIA FAMILY PRACTICE AND IMMEDIATE CARE CLINIC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D2148686

Address:
1509 W HEBRON PKWY STE 140
CARROLLTON, TX
ZIP 75010
Phone: (972) 306-0016
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RENOVAR WELLCARE PLLC is a primary care clinic center in Carrollton, TX. RENOVAR WELLCARE PLLC NPI is 1013407451. The provider is registered as an organization entity type.
The provider Is Doing Business As Essencia Family Practice And Immediate Care Clinic.

The provider's business location address is:

1509 W HEBRON PKWY STE 140
CARROLLTON, TX
ZIP 75010-492
Phone: (972) 306-0016
Fax: (972) 306-0017

The provider's authorized official is Olusesan Oluseun Olotu .
The authorized official title is Director and has the following contact phone number (972) 306-0016.

The CLIA number assigned to this NPI record is 45D2148686 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2018 and was last updated on 7/10/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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