DR. MIRANDA EFUA WELLINGTON


Address: 4927 Lake Ridge Pkwy, Suite 100, Grand Prairie, TX 75052-3087
Phone: 9726419000

DR. MIRANDA EFUA WELLINGTON (NPI# 1124314737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124314737
Entity Type Individual
Full Name DR. MIRANDA EFUA WELLINGTON
Credential M.D.
Practice Address 4927 Lake Ridge Pkwy
Suite 100
Grand Prairie
TX 75052-3087
Practice Telephone 9726419000
Mailing Telephone 9726419000
Enumeration Date 2011-06-22
Last Update Date 2014-10-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Q1768 TX Allopathic & Osteopathic Physicians

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Office Location

Street Address 4927 LAKE RIDGE PKWY
SUITE 100
City GRAND PRAIRIE
State TX
Zip Code 75052-3087

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114919677 Carolyn K Kha Optometrist 4927 Lake Ridge Pkwy, Suite Number 160, Grand Prairie, TX 75052-3073 2005-08-19
1386252831 Claire Knobbe Behavioral Analyst 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3087 2020-07-21
1053887190 Ashleigh Mills Behavior Technician 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3087 2018-10-16
1205211174 Applewhite Dental Pllc Dentist 4927 Lake Ridge Pkwy, Suite 140, Grand Prairie, TX 75052-3087 2015-07-21
1114323862 Pediatric Center of Grand Prairie Pediatrics 4927 Lake Ridge Pkwy, Suite 120, Grand Prairie, TX 75052-3087 2014-11-07
1912169210 Omar Hernandez Family Medicine 4927 Lake Ridge Pkwy, Suite 100, Grand Prairie, TX 75052-3087 2008-06-27
1497915623 Jeaneen Chappell Dermatology 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3087 2008-06-11
1275609224 Ramona Applewhite Taylor Dentist 4927 Lake Ridge Pkwy, Ste 140, Grand Prairie, TX 75052-3087 2006-11-28
1558450452 Lake Ridge Eye Care Pa Optometrist 4927 Lake Ridge Pkwy, Ste. 160, Grand Prairie, TX 75052-3073 2006-10-11
1609800911 Marsha Cox Nurse Practitioner 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3073 2006-07-10
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1487265542 Beyond Home Health Care LLC Registered Nurse 3531 Pecos Way, Grand Prairie, TX 75052 2020-08-12
1497370332 Michael Cooper Dentist 3154 South Hwy 161 Ste 640, Grand Prairie, TX 75052 2020-06-16
1043835788 Amanda Azubike Licensed Practical Nurse 4593 Mt Laurel Dr, Grand Prairie, TX 75052 2020-06-09
1457992844 Epic West Family Dnetistry Pllc Dentist 3166 Sh 161, Ste 190, Grand Prairie, TX 75052 2019-10-07
1033777487 National Vision Inc Optometrist 3166 South Highway 161, Suite 160, Grand Prairie, TX 75052 2019-05-31
1689136624 Raushanah Taherrah Shareef-jefferson Dental Hygienist 831 Ridgecrest Rd, Grand Prairie, TX 75052 2019-04-01
1053812552 Dfw Better Care Physicians, Pllc Clinic/Center 5204 Tx 360 #400, Grand Prairie, TX 75052 2018-02-21
1629586797 Grand Prairie Marvel Dental Pllc Clinic/Center 5020 S Hwy 360, Suite 200, Grand Prairie, TX 75052 2018-01-11
1033626221 Thad Taylor Iv Dds Dentist 3261 S. Carrier Pkwy., Grand Prairie, TX 75052 2018-01-09
1902312796 Real Dental Pllc Dentist 1215 W. Pioneer Pkwy, Suite 130, Grand Prairie, TX 75052 2017-12-16
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427673375 Imd Healthcare Association, Inc. Family Medicine 5857 Tory Dr, Grand Prairie, TX 75052-8500 2020-06-16
1134686926 Grand Prairie Physician Group LLC Family Medicine 517 N Carrier Pkwy Ste J, Grand Prairie, TX 75050-5484 2019-02-27
1922533322 Kelly Walthius Family Medicine 2740 N State Highway 360 Ste 100, Grand Prairie, TX 75050-6402 2017-04-24
1699158964 Gp Medical Management Group Inc Family Medicine 2634 S Carrier Pkwy Ste 105, Grand Prairie, TX 75052-5005 2015-07-06
1407237316 Bethany Wimberly Family Medicine 3095 Kingswood Blvd Ste 250, Grand Prairie, TX 75052 2015-06-16
1285047514 Shaun Gould Family Medicine 2740 N Hwy 360 Ste 100, Grand Prairie, TX 75050-6402 2014-06-04
1841543097 Omni Pain Clinic Inc Family Medicine 513 W Jefferson Blvd., Suite 170, Grand Prairie, TX 75051-1639 2012-10-24
1013238401 Ahmad Ghassan Abazid Family Medicine 4927 Lake Ridge Pkwy Ste 100, Grand Prairie, TX 75052 2010-06-20
1912157819 Cynthia Denise Mckinney Family Medicine 2520 W Interstate 20, Grand Prairie, TX 75052-7280 2008-09-26
1164697850 Crystal Renee Foster Family Medicine 4927 Lakeridge Pkwy, Suite 100, Grand Prairie, TX 75052-3087 2008-04-24
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Competitor

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City GRAND PRAIRIE
Zip Code 75052

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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