Provider Demographics
NPI:1700766847
Name:ECLIPSE HEALTH AND WELLNESS, PLLC
Entity type:Organization
Organization Name:ECLIPSE HEALTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:SARTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,APRN,PMHNP-BC
Authorized Official - Phone:214-308-2829
Mailing Address - Street 1:603 MUNGER AVE STE 100-231
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-1839
Mailing Address - Country:US
Mailing Address - Phone:214-308-2829
Mailing Address - Fax:
Practice Address - Street 1:603 MUNGER AVE STE 100-231
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-1839
Practice Address - Country:US
Practice Address - Phone:214-308-2829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic