360 Health Integrated Medical Boutique, PLLC
Organization Active NPI Family Nurse Practitioner · Arlington, TX
NPI 1730728403 · NPPES record last updated Feb 17, 2025
Key facts
- NPI
- 1730728403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- 360 HEALTH INTEGRATED MEDICAL BOUTIQUE, PLLC
- Practice address
- 1190 W Pioneer Pkwy
Arlington, TX 76013-6367 - Phone
- (682) 276-6595
- Fax
- (817) 583-6543
- NPI assigned
- Dec 30, 2019
- Organization subpart
- No
Authorized official
- Name
- Ms. Tracy Julien, FNP-C
- Title
- Family Nurse Practitioner
- Phone
- (504) 215-3919
Practitioners 1
-
Tracy Julien, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200304002020 | TX | Part B Supplier - Clinic/Group Practice | 3678900677 |
Receives reassigned benefits from 1 practitioner Practice locations: Arlington, TX |
National Provider Directory
Locations
1190 W Pioneer Pkwy
#100
Arlington, TX 76013
1190 W Pioneer Pkwy
Arlington, TX 76013
Phone (682) 276-6595
1015 Gibbins Rd
Ste C
Arlington, TX 76011
Phone (844) 423-4739
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
1190 W Pioneer Pkwy
Arlington, TX 76013-6367
Mailing address
1190 W Pioneer Pkwy
Arlington, TX 76013-6367
Phone (682) 276-6595
Other names
- Weight Away Health and Wellness
Other providers in Arlington, TX
- 1St Impression Dental Group PLLC
- 1St Prudential Health Care Services, Inc
- 1St Quality HCS & Txhml Inc
- 20-20 Express--Dallas LLC
- 301 W Randol Mill Rd Opco LLC
- 4Careplus LLC
- 4West Care & Logistics
- 5TH Avenue Grooming Lounge
- 99999999
- A & a Dental Enterprise, P.a.
All providers in Arlington, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.