Provider Demographics
NPI:1093251399
Name:APPRAISE HEALTH CLINIC, PLLC
Entity Type:Organization
Organization Name:APPRAISE HEALTH CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMORAGBON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:214-676-8716
Mailing Address - Street 1:PO BOX 2150
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-2150
Mailing Address - Country:US
Mailing Address - Phone:214-676-8716
Mailing Address - Fax:
Practice Address - Street 1:1230 RIVER BEND DR STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4916
Practice Address - Country:US
Practice Address - Phone:214-676-8716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X, 261QP2300X
TXAP127005363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care