Provider Demographics
NPI:1760980676
Name:DIRECTIONAL WELLNESS MEDICAL PARTNERS PLLC
Entity Type:Organization
Organization Name:DIRECTIONAL WELLNESS MEDICAL PARTNERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:QUERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:903-850-9116
Mailing Address - Street 1:213 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-2521
Mailing Address - Country:US
Mailing Address - Phone:903-850-9116
Mailing Address - Fax:888-882-1371
Practice Address - Street 1:213 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-2521
Practice Address - Country:US
Practice Address - Phone:903-850-9116
Practice Address - Fax:888-882-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty