Provider Demographics
NPI:1467911107
Name:TOPCARE FAMILY & WELLNESS CLINIC
Entity Type:Organization
Organization Name:TOPCARE FAMILY & WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEM
Authorized Official - Middle Name:M
Authorized Official - Last Name:TEYA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:972-212-4586
Mailing Address - Street 1:2940 BROADWAY BLVD STE 15
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-3749
Mailing Address - Country:US
Mailing Address - Phone:972-212-4586
Mailing Address - Fax:
Practice Address - Street 1:2940 BROADWAY BLVD STE 15
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3749
Practice Address - Country:US
Practice Address - Phone:972-212-4586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care