LAKEWOOD INTEGRATIVE HEALTH & WELLNESS, PLLC
NPI 1417801994
Nurse Practitioner - Family in Dallas, TX

Q: What is Lakewood Integrative Health & Wellness, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since February 23, 2026CLIA 45D2340828 · Waiver

6331 PROSPECT AVE, DALLAS, TX 75214(214) 821-6331(214) 821-6332 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Lakewood Integrative Health & Wellness, Pllc NPPES

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

LAKEWOOD INTEGRATIVE HEALTH & WELLNESS, PLLC (NPI 1417801994) is a healthcare organization registered as a family in Dallas, Texas and active in the NPI registry since February 2026. The organization holds a CLIA Waiver certificate valid through March 23, 2028 and lists Tara Nicole Cavazos, Owner, as its authorized official.

NPPES Registry Identity

NPI1417801994

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameLAKEWOOD INTEGRATIVE HEALTH & WELLNESS, PLLC

Location Address6331 PROSPECT AVEDallas, TX 75214-3938

Mailing Address6331 Prospect AveDallas, TX 75214-3938 · (214) 821-6331 · Fax (214) 821-6332

Phone(214) 821-6331

Fax(214) 821-6332

Organization SubpartNo

Authorized OfficialTara Nicole CavazosOwner · (214) 821-6331

Enumeration DateFebruary 23, 2026

NPPES CertifiedFebruary 23, 2026

✔ NPI 1417801994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

6331 PROSPECT AVE, Dallas, TX 75214

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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 45D2340828

Lakewood Integrative Health · Dallas, TX

Active · expires Mar 23, 2028

CLIA Number45D2340828

Laboratory TypePhysician Office

Certificate Effective DateMarch 24, 2026

Certificate Expiration DateMarch 23, 2028

Laboratory DirectorTara N. Cavazos

Laboratory Phone(214) 821-6331

Laboratory LocationLakewood Integrative Health6331 Prospect Ave, Dallas, TX 75214

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 11

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

MARIAH KYLIE CUNNIFF

Nurse Practitioner (Family)