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FORMULA WELLNESS PLLC
NPI 1346608536
Family Medicine in Dallas, TX

Active since February 03, 2016CLIA 45D2191410 · Waiver
4342 LOVERS LN, DALLAS, TX 75225(214) 931-9443(214) 602-2017 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Nov 25, 2016, Feb 3, 2016 (3 updates tracked since 2016).

About Formula Wellness Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORMULA WELLNESS PLLC (NPI 1346608536) is a healthcare organization registered as a family medicine in Dallas, Texas and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Brian Rudman, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1346608536
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFORMULA WELLNESS PLLC
Location Address4342 LOVERS LNDallas, TX 75225-6921
Mailing Address4342 Lovers LnDallas, TX 75225-6921 · (214) 931-9443 · Fax (214) 602-2017
Phone(214) 931-9443
Fax(214) 602-2017
Organization SubpartNo
Authorized OfficialBrian RudmanPhysician/owner · (214) 931-9443
Enumeration DateFebruary 3, 2016
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1346608536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · K1038
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedAnesthesiologyTaxonomy 207L00000X · License K1038 (TX)
Also ListedClinic/CenterTaxonomy 261Q00000X
4342 LOVERS LN, Dallas, TX 75225
Open in Google Maps ↗

Other Identifiers 1

Medicaid129767308TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2191410

Formula Wellness Park Cities · Dallas, TX
Active · expires Jun 28, 2027
CLIA Number45D2191410
Laboratory TypePhysician Office
Certificate Effective DateJune 29, 2025
Certificate Expiration DateJune 28, 2027
Laboratory DirectorBrian Rudman
Laboratory Phone(214) 931-9443
Laboratory LocationFormula Wellness Park Cities4342 Lovers Ln, Dallas, TX 75225
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH HOWER
Family Medicine
4342 LOVERS LN
DALLAS, TX 75225
Dallas County (214) 931-9443
BRIAN D RUDMAN M.D.
Family Medicine
4342 LOVERS LN
DALLAS, TX 75225
Dallas County (214) 931-9443
EMERI JEAN BRADFORD PA-C
Physician Assistant
4342 LOVERS LN
DALLAS, TX 75225
Dallas County (214) 931-9443

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Formula Wellness PLLC's NPI number?

The NPI number for Formula Wellness PLLC is 1346608536. It was assigned to this organization in the NPPES registry on February 3, 2016.

Where is Formula Wellness PLLC located?

Formula Wellness PLLC is located at 4342 Lovers Ln, Dallas, TX 75225. The listed phone number is (214) 931-9443.

What is Formula Wellness PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Formula Wellness PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2191410) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Formula Wellness PLLC was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.