NPIMap

Organization Active NPI

Southlake GYN and Wellness Center, PLLC

  • Obstetrics & Gynecology Physician
  • Southlake, TX
National Provider Identifier
1649700808
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
N1926 Issued in TX
Legal business name
SOUTHLAKE GYN AND WELLNESS CENTER, PLLC
Practice address
431 E State Highway 114 Ste 380
Southlake, TX 76092-4414
Phone
(817) 280-9616
Fax
(817) 722-6328
NPI assigned
Jun 19, 2017
Organization subpart
No

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
Miriam M Torres, MDNPI 1467528711
Title
Owner
Phone
(817) 280-9616

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X N1926 TX Primary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X 41197 KY

Addresses

Primary practice location

431 E State Highway 114 Ste 380
Southlake, TX 76092-4414

Mailing address

431 E State Highway 114 Ste 380
Southlake, TX 76092-4414
Phone (817) 280-9616

Other practice location 1

220 N Park Blvd Ste 100
Grapevine, TX 76051-6900
Phone (817) 280-9616

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1649700808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 E STATE HIGHWAY 114 STE 380",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924414",
            "telephone_number": "817-280-9616",
            "fax_number": "817-722-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E STATE HIGHWAY 114 STE 380",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924414",
            "telephone_number": "817-280-9616",
            "fax_number": "817-722-6328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 N Park Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760516900",
            "country_code": "US",
            "telephone_number": "817-280-9616",
            "fax_number": "817-722-6328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHLAKE GYN AND WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-280-9616",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N1926",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "41197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, 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.