Provider Demographics
NPI:1609765726
Name:LIVE WELLNESS SURGICAL, PLLC
Entity type:Organization
Organization Name:LIVE WELLNESS SURGICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KANENECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:UBESIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:972-850-6122
Mailing Address - Street 1:8700 STONEBROOK PKWY UNIT 958
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4333 N JOSEY LN STE 101
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4620
Practice Address - Country:US
Practice Address - Phone:972-850-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty