Provider Demographics
NPI:1700328325
Name:DANIEL HEALTH & WELLNESS, PLLC
Entity Type:Organization
Organization Name:DANIEL HEALTH & WELLNESS, PLLC
Other - Org Name:NOIRE SKIN AND HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAVONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADUBA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:972-846-0448
Mailing Address - Street 1:17762 PRESTON RD STE 114
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5730
Mailing Address - Country:US
Mailing Address - Phone:972-846-0448
Mailing Address - Fax:972-502-9548
Practice Address - Street 1:17430 CAMPBELL RD STE 207
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5212
Practice Address - Country:US
Practice Address - Phone:972-846-0448
Practice Address - Fax:972-502-9548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130091261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care