Lord and Lady Wellness & Aesthetics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LORD AND LADY WELLNESS & AESTHETICS

Doing business as

Maverick Medical Care

Practice address

5001 TX 114
Apt 4102
Northlake, TX 76262

Phone

(817) 918-8725

Fax

(682) 316-9277

NPI assigned

Aug 12, 2022

Last updated

Aug 17, 2022By 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

Farrah Christian, NPNPI 1033698352

Title

Owner

Phone

(817) 751-8118

Specialties & licenses 1

Addresses

Other names 1

• Maverick Medical Care Doing business as

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.

• Farrah Christian, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1033698352
  NPD Authorized official

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1821726191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 TX 114",
            "address_2": "APT 4102",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-918-8725",
            "fax_number": "682-316-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 TX 114",
            "address_2": "APT 4102",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-918-8725",
            "fax_number": "682-316-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORD AND LADY WELLNESS & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "FARRAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-751-8118",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Medical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shireen Khan, LMFT-ASSOCIATE
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• Marshall Franklin Koen III, RPH
• Judy D Lamb, PH.D., MSCP
• Life Changes Physical Therapy LLC
• Nahla Ibrahim Lorenzi, MD
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• Rebecca Loving, RN, IBCLC
• Maria Guadalupe Madera, DDS
• Mansell Family Dentistry & Orthodontics

• Primary Care Clinic/Center in Northlake, TX
• Providers in Northlake, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.