Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southlake GYN and Wellness Center, PLLC

Organization Obstetrics & Gynecology Physician · NPI 1649700808

Southlake GYN and Wellness Center, PLLC provides Obstetrics & Gynecology Physician services in Southlake, Texas. Works from 2 locations. Licensed in Kentucky and Texas.

Licensed in
KY, TX
In the registry since
2017
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

431 E State Highway 114 Ste 380
Southlake, TX 76092-4414
Phone: (817) 280-9616
Fax: (817) 722-6328
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 220 N Park Blvd Ste 100, Grapevine, TX 76051-6900 — (817) 280-9616

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence N1926 (TX)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 41197 (KY)

Record details

NPI number1649700808
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Miriam Torres — Owner · (817) 280-9616
NPI enumeratedJune 19, 2017
Last updated in NPPESSeptember 1, 2026
Certification dateSeptember 1, 2026
Mailing address431 E State Highway 114 Ste 380, Southlake, TX 76092-4414

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