Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lifelong Wellness Clinic PLLC

Organization Family Medicine Physician · NPI 1114205812

Lifelong Wellness Clinic PLLC provides Family Medicine Physician services in Eastland, Texas. Licensed in Texas. Registered with an NPI since 2011.

Licensed in
TX
In the registry since
2011
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

711 W Main St
Eastland, TX 76448-2534 Not confirmed with CMS for 12 years — call before visiting
Phone: (254) 629-1100
Fax: (254) 629-1104
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence N2319 (TX)
Pediatrics Physician Taxonomy 208000000X · Licence P0309 (TX)

Record details

NPI number1114205812
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christopher Tidroski — Owner · (254) 629-1100
NPI enumeratedJuly 28, 2011
Last updated in NPPESOctober 23, 2013
Mailing address711 W Main St, Eastland, TX 76448-2534

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