CUSTOMMADEIMAGEHEALTH AND WELLNESS – NPI #1417730631
Registered Nurse

CUSTOMMADEIMAGEHEALTH AND WELLNESS is a registered nurse (RN) located in ALLEN, TX. NPPES has assigned the NPI number 1417730631 to CUSTOMMADEIMAGEHEALTH AND WELLNESS on August 14, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 163WP0809X from the Health Care Provider Taxonomy code set, which is classified as Registered Nurse, specializing in Psychiatric/Mental Health, Adult

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CUSTOMMADEIMAGEHEALTH AND WELLNESS below.

NPI Profile for
CUSTOMMADEIMAGEHEALTH AND WELLNESS

NPI Number
1417730631
Enumeration Date

(about 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CUSTOMMADEIMAGEHEALTH AND WELLNESS
Primary location
825 WATTERS CREEK BLVD STE 250
ALLEN, TX 75013-3770
Phone: (214) 945-3702 Fax:
Mailing address
1972 SUNNY SIDE DR
LITTLE ELM, TX 75068-7803
Phone: (214) 797-8767 Fax:
Organization Subpart
No
Authorized Official
TONYA WILLIAMS
NURSE PRACTITIONER
Phone: (214) 945-3702
Updated
Certification Date
Aug 14, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
163WP0809X
- Registered Nurse / Psychiatric/Mental Health, Adult (Primary)
363LP2300X
- Nurse Practitioner / Primary Care

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.