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Organization
MLTD ENTERPRISES LLC
Active
Organization
MLTD ENTERPRISES LLC
Active
Other names
Guys & Gals Hormones and Hydration
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH DUKE APRN (OWNER/MANAGER)
(940) 206-5207
Entity
Organization
Contact information
Practice address
1001 TRAVIS RANCH BLVD, STE 1, FORNEY, TX 75126
(469) 910-1842
Mailing address
1009 E INTERSTATE 30 STE 1074, ROCKWALL, TX 75087-4826
(940) 206-5207
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
363LX0106X
Occupational Health Nurse Practitioner
—
—
Other
Enumeration date
04/06/2023
Last updated
01/04/2024
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