Organization
WELLNESS CARE CENTER OF IRVING, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH DIANE DURHAM (ADMINISTRATOR)
(469) 831-2541
Entity
Organization
Contact information
Practice address
111 FERGUSON CT, IRVING, TX 75062-7014
(972) 353-5437
(800) 669-2161
Mailing address
111 FERGUSON CT, IRVING, TX 75062-7014
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287022201
—
TX
Enumeration date
08/11/2017
Last updated
02/26/2024
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