Provider Demographics
NPI:1457993297
Name:TEXANS HEALTH & WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:TEXANS HEALTH & WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAYE
Authorized Official - Middle Name:C
Authorized Official - Last Name:KRUBALLY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:972-303-0861
Mailing Address - Street 1:760 BELVEDERE PARK LN
Mailing Address - Street 2:
Mailing Address - City:LUCAS
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8853
Mailing Address - Country:US
Mailing Address - Phone:972-303-0861
Mailing Address - Fax:972-303-0928
Practice Address - Street 1:4125 BROADWAY BLVD STE 120C
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-2500
Practice Address - Country:US
Practice Address - Phone:972-303-0861
Practice Address - Fax:972-303-0928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Single Specialty