Organization · NPI-2

360 Health Integrated Medical Boutique, PLLC

Nurse Practitioner, Family · Arlington, TX

NPI number1730728403

StatusActive

Last updated in NPPESFeb 17, 2025

Details

NPI: 1730728403
Entity type: Organization (NPI-2)
Legal business name: 360 Health Integrated Medical Boutique, PLLC
Organization subpart: No
Enumeration date: Dec 30, 2019
Certification date: Feb 17, 2025
Last updated: Feb 17, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	–	–	Yes

Other names

Weight Away Health And Wellness (Former Legal Business Name)
Weight Away Health And Wellness (Doing Business As)

Practice location

1190 W Pioneer Pkwy
Arlington, TX 76013-6367

Phone 682-276-6595 · Fax 817-583-6543

Mailing address

1190 W Pioneer Pkwy
Arlington, TX 76013-6367

Phone 682-276-6595 · Fax 817-583-6543

Authorized official

Tracy Julien
Family Nurse Practitioner
5042153919

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