Provider Demographics
NPI:1386220382
Name:A&A MEDICAL HOLDINGS
Entity Type:Organization
Organization Name:A&A MEDICAL HOLDINGS
Other - Org Name:INNOVAFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WIRLEN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:469-756-1711
Mailing Address - Street 1:26875 US HIGHWAY 380 E STE 200
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-8063
Mailing Address - Country:US
Mailing Address - Phone:469-338-7090
Mailing Address - Fax:469-519-1542
Practice Address - Street 1:26919 US HIGHWAY 380 E STE 200
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-0239
Practice Address - Country:US
Practice Address - Phone:469-907-9985
Practice Address - Fax:469-519-5595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A&A MEDICAL HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-20
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Single Specialty