Live Well MD PA

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G1042 Issued in TX

Legal business name

LIVE WELL MD PA

Practice address

4808 S Buckner Blvd
Dallas, TX 75227-2348

Phone

(214) 388-4808

NPI assigned

Jul 7, 2011

Organization subpart

No

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

Authorized official

Name

Henry T Horrilleno, MD

Title

Owner

Phone

(214) 388-4808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1265729453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 S BUCKNER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752272348",
            "telephone_number": "214-388-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 S BUCKNER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752272348",
            "telephone_number": "214-388-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "HORRILLENO",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-388-4808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "G1042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhengshan Liu
• Liv Center for Reproductive Healing
• Live More Simply, Inc
• Live More Simply, Inc
• Live Oak OBGYN, LLP
• Live Young, PA
• Mary Michelle Lively, NP-C
• Timothy Warren Livengood II, M.D.
• Liver Center of Texas, PLLC
• Raymond Eugene Liverman Jr., D.C.

• Vascular Surgery Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.