NPIMap

Organization Active NPI

Restorative Therapy & Wellness Spa, Inc.

  • Health & Wellness Coach
  • Grand Prairie, TX
National Provider Identifier
1225752165
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Legal business name
RESTORATIVE THERAPY & WELLNESS SPA, INC.
Practice address
2100 N Hwy 360 Ste 2007B
Grand Prairie, TX 75050-1045
Phone
(214) 384-6466
NPI assigned
Oct 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Latwanya Janea Traylor, NPNPI 1093955536
Title
Managing Member
Phone
(214) 384-6466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness CoachGroup: 193400000X SINGLE SPECIALTY GROUP 171400000X Primary

Addresses

Primary practice location

2100 N Hwy 360 Ste 2007B
Grand Prairie, TX 75050-1045

Mailing address

2100 N Hwy 360 Ste 2007B
Grand Prairie, TX 75050-1045
Phone (214) 384-6466

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1225752165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N HWY 360 STE 2007B",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501045",
            "telephone_number": "214-384-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N HWY 360 STE 2007B",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501045",
            "telephone_number": "214-384-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE THERAPY & WELLNESS SPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "LATWANYA",
        "authorized_official_middle_name": "JANEA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-384-6466",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.