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General NPI Number Information
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NPI Number | 1013292416
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Entity Type | Organization
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Legal Business Name | STRATEGIC WELLNESS & HEALTH
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 1051 PINELOCH DR STE 800
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City | HOUSTON
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State | TX
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Zip | 77062-2738
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Country | US
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Telephone | 832-284-4043
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Fax | 832-284-4048
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Provider Business Mailing Address
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Address Line | 1051 PINELOCH DR STE 800
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City | HOUSTON
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State | TX
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Zip | 77062-2738
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Country | US
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Telephone | 832-284-4043
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Fax | 832-284-4048
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAN FAUST
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Credential |
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Telephone | 832-284-4043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | N-3575
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License Number State | TX
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