Provider Demographics
NPI:1740936376
Name:WILNA SPRINGS LLC
Entity type:Organization
Organization Name:WILNA SPRINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:SULEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:316-993-4541
Mailing Address - Street 1:2617 FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5986
Mailing Address - Country:US
Mailing Address - Phone:817-630-6003
Mailing Address - Fax:817-549-1827
Practice Address - Street 1:2617 FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5986
Practice Address - Country:US
Practice Address - Phone:817-630-6003
Practice Address - Fax:817-549-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty