Organization Active NPI

Healthco Executive Wellness

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1578403184
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HEALTHCO EXECUTIVE WELLNESS
Practice address
1401 W Jefferson Blvd
Dallas, TX 75208-5326
Phone
(469) 708-7454
NPI assigned
Mar 31, 2026
Organization subpart
Yes
Parent organization
CAINE HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Authorized official

Name
Nenna NwazotaNPI 1063706844
Title
MD
Phone
(469) 708-7454

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
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1401 W Jefferson Blvd
Dallas, TX 75208-5326

Mailing address

1401 W Jefferson Blvd
Dallas, TX 75208-5326

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1774915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1578403184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W JEFFERSON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W JEFFERSON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085326",
            "telephone_number": "469-708-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCO EXECUTIVE WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAINE HOLDINGS LLC",
        "enumeration_date": "2026-03-31",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "NWAZOTA",
        "authorized_official_first_name": "NENNA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "469-708-7454"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.