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NPI Code Detail

MEDICARE: X-PERT WELLNESS, PA

MEDICARE: X-PERT WELLNESS, PA
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1427391762
Entity Type Code : Organization
Provider Name (Legal Business Name) : X-PERT WELLNESS, PA
Provider Business Mailing Address
First Line : 3319 WILD RIV
Second Line :
City : RICHMOND
State : TX
Zip : 77406-2488
Country : US
Telephone Number : 281-773-2758
Fax Number :
Provider Business Practice Location Address
First Line : 8989 WESTHEIMER RD
Second Line : #320
City : HOUSTON
State : TX
Zip : 77063-3621
Country : US
Telephone Number : 713-772-7246
Fax Number : 713-772-9657
Authorized Official
Title or Position : DIRECTOR
Name : DR. AYO A AJIM
Credential : MD
Telephone Number : 281-773-2758
Provider Enumeration Date : 04/05/2013
Last Update Date : 04/05/2013

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Directions to “X-PERT WELLNESS, PA ” Practice Location

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