Provider Demographics
NPI:1679102313
Name:NORTH TEXAS INTEGRATIVE HEALTH & WELLNESS
Entity type:Organization
Organization Name:NORTH TEXAS INTEGRATIVE HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAROLYN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:DIHIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, CPNP, FNP
Authorized Official - Phone:214-478-8123
Mailing Address - Street 1:916 DARBYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1664
Mailing Address - Country:US
Mailing Address - Phone:214-478-8123
Mailing Address - Fax:
Practice Address - Street 1:400 E ROYAL LN STE 212
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3512
Practice Address - Country:US
Practice Address - Phone:469-340-0979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty