Provider Demographics
NPI:1710425897
Name:PLANO WELLNESS, PLLC
Entity Type:Organization
Organization Name:PLANO WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-535-8000
Mailing Address - Street 1:3060 COMMUNICATIONS PKWY
Mailing Address - Street 2:#105
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8449
Mailing Address - Country:US
Mailing Address - Phone:972-535-8000
Mailing Address - Fax:
Practice Address - Street 1:3060 COMMUNICATIONS PKWY
Practice Address - Street 2:#105
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8449
Practice Address - Country:US
Practice Address - Phone:972-535-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1971207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty