Eldorado Total Wellness Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELDORADO TOTAL WELLNESS CLINIC PLLC

Practice address

5000 Eldorado Pkwy Ste 420
Frisco, TX 75033-8612

Phone

(469) 598-1200

Fax

(972) 637-9272

NPI assigned

Mar 29, 2021

Organization subpart

No

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

Authorized official

Name

Dan Richardson

Title

Director of Billing

Phone

(469) 598-1200

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1285211771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 ELDORADO",
            "address_2": "BOX 150-153",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75033",
            "telephone_number": "469-598-1200",
            "fax_number": "972-637-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 ELDORADO PKWY STE 420",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750338612",
            "telephone_number": "469-598-1200",
            "fax_number": "972-637-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDORADO TOTAL WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "469-598-1200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.