Healthcare Provider Details

I. General information

NPI: 1972466035
Provider Name (Legal Business Name): WELLNESSOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8911 N CAPITAL OF TEXAS HWY STE 4200
AUSTIN TX
78759-7439
US

IV. Provider business mailing address

8911 N CAPITAL OF TEXAS HWY STE 4200
AUSTIN TX
78759-7439
US

V. Phone/Fax

Practice location:
  • Phone: 512-541-8612
  • Fax:
Mailing address:
  • Phone: 512-541-8612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESUS VALIENTE JR.
Title or Position: MANAGING MEMBER
Credential: M.A., LPC
Phone: 512-541-8612