GLC Wellness Center Texas LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

GLC WELLNESS CENTER TEXAS LLC

Practice address

777 E Wheatland Rd Ste 106
Duncanville, TX 75116-4918

Phone

(702) 587-8106

Fax

(972) 685-5108

NPI assigned

Aug 23, 2019

Last updated

Jun 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dante Young

Title

Ceo

Phone

(702) 587-8106

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 24

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.

• Tenesia Nicole Moore, APRN, FNP-C

  • Family Nurse Practitioner
  • Duncanville, TX
  • NPI 1740733740
  Medicare reassignment Care Compare group NPD
• Angelica Torres Yrigollen, FNP-BC

  • Family Nurse Practitioner
  • Duncanville, TX
  • NPI 1750536462
  Medicare reassignment Care Compare group NPD
• Dennis Rahim Abbas, M.D.

  • Obstetrics & Gynecology Physician
  • Dallas, TX
  • NPI 1013928720
  Medicare reassignment NPD
• Shola Philip Akinfiresoye, DNP, FNP-BC

  • Family Nurse Practitioner
  • Duncanville, TX
  • NPI 1104339373
  Medicare reassignment NPD
• Kristina M Byrd-Joseph, LCSW

  • Clinical Social Worker
  • Frisco, TX
  • NPI 1790297562
  Medicare reassignment NPD
• Valarie Denise Crawford, APRN

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1578062089

  Multi-Specialty

  Medicare reassignment NPD
• Tricia Davis, LCSW

  • Clinical Social Worker
  • Dallas, TX
  • NPI 1447561394
  Medicare reassignment NPD
• Dralves G Edwards, DO

  • General Practice Physician
  • Duncanville, TX
  • NPI 1568401701
  Medicare reassignment NPD
• Edward Galvan, NP

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1891115614
  Medicare reassignment NPD
• Jeffrey Carl Patterson, D.O.

  • Emergency Medicine Physician
  • Abilene, TX
  • NPI 1932166378

  Single Specialty

  Medicare reassignment NPD
• Murray Robert Strauss, M.D.

  • General Practice Physician
  • Arlington, TX
  • NPI 1568655652
  Medicare reassignment NPD
• Mofoluwasho Adenekan, FNP

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1407460207

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1700433653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E WHEATLAND RD STE 106",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164918",
            "telephone_number": "702-587-8106",
            "fax_number": "972-685-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E WHEATLAND RD STE 106",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164918",
            "telephone_number": "702-587-8106",
            "fax_number": "972-685-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLC WELLNESS CENTER TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-06-30",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DANTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-587-8106"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455039503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405039502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405039504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405039501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.GLCWELLNESS.COM",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1251 E Red Bird Ln Ste A",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752412008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Travicia Lacole Garrett, RN, FNP-C
• Ann Wanjiru Gathura, BCBA
• Diane Barnes Gawedzinski, L.P.C.
• Geneye Inc. (Duncanville Eye Association and/or Duncanville Optical)
• Helen D Gipson, DPM
• Glennwood Enterprises, Inc (Heritage HomeCare)
• Glory Able Home Healthcare Inc (Savior Home Health Inc)
• Glory Financial Services (Glory Decorations & Party Suppliy)
• Ebony Goggins
• Golden Gate Adult Day Care (Envision Diagnostic Ultrasound)

• General Practice Physician in Duncanville, TX
• Providers in Duncanville, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.