National Provider Identifier Database

GLC WELLNESS CENTER TEXAS LLC
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

GLC WELLNESS CENTER TEXAS LLC
1251 E RED BIRD LN STE A
DALLAS, TX75241
Phone: 702-587-8106
Fax: 972-685-5108
Specialty Taxonomy Code
* General Practice 208D00000X
Mental Health 101YM0800X

* Indicates primary specialty

NPI Profile & details for GLC WELLNESS CENTER TEXAS LLC

NPI Number 1700433653
Legal business name
LBN
GLC WELLNESS CENTER TEXAS LLC
Authorized official DANTE YOUNG - (CEO)
Entity Organization
Organization subpart No
Enumeration date 08/23/2019
Last updated 06/30/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • TX Medicaid: 405039501
  • TX Medicaid: 405039502
  • TX Medicaid: 405039504
  • TX Medicaid: 455039503

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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