MEDICARE: NI9 HEALTH GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	3336C0004X	Compounding Pharmacy

General Provider Information

NPI Number	:	1215654215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NI9 HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	16402 FM 2920 RD BLDG D
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77377-6431
Country	:	US
Telephone Number	:	832-209-1400
Fax Number	:	346-307-3155

Provider Business Practice Location Address
First Line	:	16402 FM 2920 RD BLDG D
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77377-6431
Country	:	US
Telephone Number	:	832-209-1400
Fax Number	:	346-307-3155

Authorized Official
Title or Position	:	OFFICER
Name	:	MR. KYLE MARTENS
Credential	:
Telephone Number	:	832-209-1400

Provider Enumeration Date	:	10/21/2022
Last Update Date	:	04/06/2026

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Directions to “NI9 HEALTH GROUP LLC ” Practice Location

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