Provider Demographics
NPI:1144060971
Name:JWE PLLC
Entity type:Organization
Organization Name:JWE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-505-0833
Mailing Address - Street 1:4300 MACARTHUR AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-6544
Mailing Address - Country:US
Mailing Address - Phone:214-434-1175
Mailing Address - Fax:
Practice Address - Street 1:4300 MACARTHUR AVE STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-6544
Practice Address - Country:US
Practice Address - Phone:214-434-1175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty