# LIVE WELL MD PA

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265729453
- **Authorized official:** HENRY T HORRILLENO MD (OWNER)
- **Authorized official phone:** (214) 388-4808

## Contact information

- **Practice address:** 4808 S BUCKNER BLVD, DALLAS, TX 75227-2348
- **Practice address phone:** (214) 388-4808
- **Mailing address:** 4808 S BUCKNER BLVD, DALLAS, TX 75227-2348
- **Mailing address phone:** (214) 388-4808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | G1042 | TX | Yes |

## Other

- **Enumeration date:** 07/07/2011
- **Last updated:** 07/07/2011