Healthcare Provider Details

I. General information

NPI: 1659497360
Provider Name (Legal Business Name): KOALA HEALTH & WELLNESS TESTING & PERFORMANCE CENTERS, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 W SAM HOUSTON PKWY N
HOUSTON TX
77043-1606
US

IV. Provider business mailing address

PO BOX 890389
HOUSTON TX
77289-0389
US

V. Phone/Fax

Practice location:
  • Phone: 713-463-9111
  • Fax: 713-329-9126
Mailing address:
  • Phone: 281-286-8520
  • Fax: 281-286-2947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF006339
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateTX

VIII. Authorized Official

Name: MARY DOYLE
Title or Position: OWNER
Credential:
Phone: 713-463-9111