Healthcare Provider Details

I. General information

NPI: 1649666710
Provider Name (Legal Business Name): STRATEGIC WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DIAMOND OAK CT
THE WOODLANDS TX
77381-3454
US

IV. Provider business mailing address

6 DIAMOND OAK CT
THE WOODLANDS TX
77381-3454
US

V. Phone/Fax

Practice location:
  • Phone: 281-674-8463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SEAN M. BAKER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 281-674-8463