Healthcare Provider Details
I. General information
NPI: 1750577375
Provider Name (Legal Business Name): THE WELLNESS ASSOCIATES OF HOUSTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
440 BENMAR DR STE 2230
HOUSTON TX
77060-3169
US
IV. Provider business mailing address
440 BENMAR DR STE 2230
HOUSTON TX
77060-3169
US
V. Phone/Fax
- Phone: 281-999-5220
- Fax:
- Phone: 281-999-5220
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MICHELLE
MOUTON
Title or Position: DIRECTOR
Credential:
Phone: 281-999-5220