Healthcare Provider Details

I. General information

NPI: 1174093348
Provider Name (Legal Business Name): YOURX HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 05/23/2022
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26710 I H 45 STE C200
SPRING TX
77386-1019
US

IV. Provider business mailing address

3311 YUPON ST APT 614
HOUSTON TX
77006-3861
US

V. Phone/Fax

Practice location:
  • Phone: 832-585-0456
  • Fax:
Mailing address:
  • Phone: 409-781-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT CASIMIR
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 832-279-2369