Provider Demographics
NPI:1992542112
Name:PMI WELLNESS GROUP PLLC
Entity type:Organization
Organization Name:PMI WELLNESS GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:IYKE
Authorized Official - Last Name:IGBOKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-469-4213
Mailing Address - Street 1:1525 US HIGHWAY 380 STE 500 #331
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0176
Mailing Address - Country:US
Mailing Address - Phone:214-469-4213
Mailing Address - Fax:
Practice Address - Street 1:14605 PRAIRIE FIRE DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-7028
Practice Address - Country:US
Practice Address - Phone:214-469-4213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)