# LOVE FIELD CLINIC PLANO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinica Hispana Vida Sana
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740997220
- **Authorized official:** MR. RAFAEL LUIS FONSECA FNP-C (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (469) 277-8858

## Contact information

- **Practice address:** 2300 14TH ST STE 145, PLANO, TX 75074-6445
- **Practice address phone:** (469) 277-8858
- **Practice address fax:** (469) 001-9543
- **Mailing address:** 2300 14TH ST STE 145, PLANO, TX 75074-6445
- **Mailing address phone:** (469) 277-8858
- **Mailing address fax:** (469) 001-9543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2022
- **Last updated:** 09/09/2024