Organization
LOVEDALE ENTERPRISES
Active
Other names
Elysian Health
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAIL SHAKOOR BOODHWANI APRN (OWNER)
(214) 430-4384
Entity
Organization
Contact information
Practice address
2100 W COLORADO BLVD, DALLAS, TX 75211-1900
(214) 430-4384
(214) 430-4608
Mailing address
2100 W COLORADO BLVD, DALLAS, TX 75211-1900
(214) 943-4631
(877) 416-0310
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
02/23/2024
Last updated
08/29/2024
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