SOUTHLAKE GYN AND WELLNESS CENTER is an obstetrics gynecology in Grapevine, TX. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. SOUTHLAKE GYN AND WELLNESS CENTER NPI is 1649700808. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider's business location address is:
220 N PARK BLVD STE 100
GRAPEVINE, TX
ZIP 76051-900
Phone: (817) 280-9616
Fax: (817) 722-6328
The provider's authorized official is Miriam M Torres .
The authorized official title is Owner and has the following contact phone number (817) 280-9616.
The CLIA number assigned to this NPI record is 45D2165989 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/19/2017 and was last updated on 6/11/2019.