Healthcare Provider Details

I. General information

NPI: 1720867963
Provider Name (Legal Business Name): TEXAS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 CAPLIN ST
HOUSTON TX
77022-5604
US

IV. Provider business mailing address

916 CAPLIN ST
HOUSTON TX
77022-5604
US

V. Phone/Fax

Practice location:
  • Phone: 832-528-5537
  • Fax:
Mailing address:
  • Phone: 832-528-5537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHIBUISI FRANK NNAM
Title or Position: CEO
Credential:
Phone: 832-528-5537