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Organization
FORMULA WELLNESS PLLC
Active
Organization
FORMULA WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN RUDMAN M.D. (PHYSICIAN/OWNER)
(214) 931-9443
Entity
Organization
Contact information
Practice address
4342 LOVERS LN, DALLAS, TX 75225-6921
(214) 931-9443
(214) 602-2017
Mailing address
4342 LOVERS LN, DALLAS, TX 75225-6921
(214) 931-9443
(214) 602-2017
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
K1038
TX
207Q00000X
Family Medicine Physician
Primary
K1038
TX
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
02/03/2016
Last updated
07/21/2022
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