Provider Demographics
NPI:1427671981
Name:STAYING HEALTHY WELLNESS LLC
Entity type:Organization
Organization Name:STAYING HEALTHY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-569-7162
Mailing Address - Street 1:4505 MAHOGANY LN
Mailing Address - Street 2:
Mailing Address - City:COPPER CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:75077-8546
Mailing Address - Country:US
Mailing Address - Phone:469-569-7162
Mailing Address - Fax:
Practice Address - Street 1:4700 DEXTER DR STE 300B
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5294
Practice Address - Country:US
Practice Address - Phone:877-846-5944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty