Healthcare Provider Details

I. General information

NPI: 1306750047
Provider Name (Legal Business Name): NIA WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 MERTON DR
LEANDER TX
78641-3782
US

IV. Provider business mailing address

2512 MERTON DR
LEANDER TX
78641-3782
US

V. Phone/Fax

Practice location:
  • Phone: 737-245-4899
  • Fax:
Mailing address:
  • Phone: 737-245-4899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ANTANIA BARNES PRIESTER
Title or Position: OWNER
Credential: LBS, CPC
Phone: 737-245-4899