Healthcare Provider Details

I. General information

NPI: 1699597104
Provider Name (Legal Business Name): INTEGRATIVE HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2024
Last Update Date: 10/26/2024
Certification Date: 10/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13574 UNIVERSITY BLVD STE 950
SUGAR LAND TX
77479-6868
US

IV. Provider business mailing address

5318 VIOLET RIDGE DR
RICHMOND TX
77469-3829
US

V. Phone/Fax

Practice location:
  • Phone: 281-903-7777
  • Fax:
Mailing address:
  • Phone: 713-392-6097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCOS AFONSO
Title or Position: OWNER
Credential:
Phone: 832-847-3129