Healthcare Provider Details

I. General information

NPI: 1154604569
Provider Name (Legal Business Name): HOLISTEX HEALTH CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SLOSSEN ST
WEBSTER TX
77598-5043
US

IV. Provider business mailing address

16516 EL CAMINO REAL # 207
HOUSTON TX
77062-5723
US

V. Phone/Fax

Practice location:
  • Phone: 281-948-8707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number7170
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number776714
License Number StateTX

VIII. Authorized Official

Name: DR. GREGORY MROZINSKI
Title or Position: PRESIDENT
Credential: R.N., F.N.P., D.C.
Phone: 281-948-8707