Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
GRAPEVINE TOTAL WELLNESS PLLC
Active
Organization
GRAPEVINE TOTAL WELLNESS PLLC
Active
Parent organization
MODERN MALE T-CLINIC, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MODERN MALE T-CLINIC, P.A.
Authorized official
SALVATORE CAMPO DO (PHYSICIAN/PRESIDENT)
(800) 246-5698
Entity
Organization
Contact information
Practice address
1000 W ST HWY 114, GRAPEVINE, TX 76051-3987
(800) 246-5698
Mailing address
5000 ELDORADO PKWY STE 150-153, FRISCO, TX 75033-8695
(800) 246-5698
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
06/11/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers