Provider Demographics
NPI:1407201932
Name:MY HEALTH AND SUCCESS CONSULTING
Entity Type:Organization
Organization Name:MY HEALTH AND SUCCESS CONSULTING
Other - Org Name:HEALTHY HOUSE-CALL PROVIDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN, FNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:IMOH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:214-642-5181
Mailing Address - Street 1:1523 SUMMERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1829
Mailing Address - Country:US
Mailing Address - Phone:468-888-3328
Mailing Address - Fax:469-533-3732
Practice Address - Street 1:9304 FOREST LN STE S-100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:469-577-4009
Practice Address - Fax:469-553-7778
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MY HEALTH AND SUCCESS CONSULTING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-03
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130766261QH0100X
261QP2300X, 363LF0000X, 363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX506075Medicare PIN
TX506084ZVBLMedicare PIN