Provider Demographics
NPI:1407344674
Name:ON EAGLES WINGS, INC
Entity Type:Organization
Organization Name:ON EAGLES WINGS, INC
Other - Org Name:WOVEN HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGBY
Authorized Official - Suffix:
Authorized Official - Credentials:EMBA
Authorized Official - Phone:972-755-4656
Mailing Address - Street 1:1 MEDICAL PKWY
Mailing Address - Street 2:PLAZA ONE, SUITE 149
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234
Mailing Address - Country:US
Mailing Address - Phone:972-484-8444
Mailing Address - Fax:972-484-0051
Practice Address - Street 1:1 MEDICAL PKWY
Practice Address - Street 2:PLAZA ONE, SUITE 149
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:972-484-8444
Practice Address - Fax:972-484-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty