OrganizationActive
Wholelife Authentic Care Provider Network
NPI 1386200889 · General Practice Physician · Fort Worth, TX
Provider details
- NPI number
- 1386200889
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nicole Havrilla, Board President(806) 220-6455
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1000 Bonnie Brae Ave Ste 120
Fort Worth, TX 76111-4301
Phone: (817) 706-3128
Street-level locationGet directions
Mailing address
Po Box 11043
Fort Worth, TX 76110-0043
Registry dates
- Enumerated
- 2019-05-10
- Last updated
- 2022-06-10
- Certified
- 2022-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.