Healthcare Provider Details

I. General information

NPI: 1265079230
Provider Name (Legal Business Name): PRIORITY HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 CULLEN PKWY STE 202
PEARLAND TX
77581-9008
US

IV. Provider business mailing address

2620 CULLEN BLVD STE. 202
PEARLAND TX
77581
US

V. Phone/Fax

Practice location:
  • Phone: 281-962-4183
  • Fax: 281-412-4020
Mailing address:
  • Phone: 281-962-4183
  • Fax: 281-412-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH PEREZ
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 713-319-5665