Healthcare Provider Details

I. General information

NPI: 1780928226
Provider Name (Legal Business Name): COSMOPOLITAN WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2012
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7627 W GRAND PKWY S STE 400
RICHMOND TX
77407-8695
US

IV. Provider business mailing address

7627 W GRAND PKWY S STE 400
RICHMOND TX
77407-8695
US

V. Phone/Fax

Practice location:
  • Phone: 832-615-2765
  • Fax: 832-201-0901
Mailing address:
  • Phone: 832-615-2765
  • Fax: 832-201-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: LEKA GAJULA
Title or Position: PRESIDENT
Credential: MD
Phone: 832-615-2765