MEDICARE: MOVE FUNCTIONAL WELLNESS 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1831778927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOVE FUNCTIONAL WELLNESS LLC

Provider Business Mailing Address
First Line	:	1725 MAIN ST # 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 MAIN ST # 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8142
Country	:	US
Telephone Number	:	832-349-0210
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATANIA BOOKER
Credential	:	MD
Telephone Number	:	832-349-0210

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	04/06/2021

Similar Medicare Providers

1972002525 — L CAMP LLC
Practice Location Address:

1725 MAIN ST STE 2
HOUSTON, TX
77002-8142

Practice Phone: 832-285-6052
Practice Fax:

1972511269 — MR. CHAD A ELMS PT
Practice Location Address:

2020 NORTH LOOP W STE 135
HOUSTON, TX
77018-8142

Practice Phone: 210-372-9600
Practice Fax: 210-372-9923

1891129607 — JEREMY C WINDHAM PT
Practice Location Address:

2020 NORTH LOOP W STE 135
HOUSTON, TX
77018-8142

Practice Phone: 281-524-6488
Practice Fax:

1619351228 — AMPT, LLC
Practice Location Address:

2020 NORTH LOOP W STE 135
HOUSTON, TX
77018-8142

Practice Phone: 281-816-7891
Practice Fax: 281-674-8276

1437625449 — DIEDRE SHEPARD FNP-BC
Practice Location Address:

1201 FANNIN ST STE 262
HOUSTON, TX
77002-6943

Practice Phone: 866-849-0692
Practice Fax: 888-973-8821

1215746128 — JENNIFER KUNDAK
Practice Location Address:

700 MILAM ST STE 1300
HOUSTON, TX
77002-2736

Practice Phone: 877-418-2978
Practice Fax:

Directions to “MOVE FUNCTIONAL WELLNESS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.