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General NPI Number Information
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NPI Number | 1164027314
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Entity Type | Organization
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Legal Business Name | ELEVATE HEALTH & WELLNESS
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 33300 EGYPT LN STE A800
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City | MAGNOLIA
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State | TX
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Zip | 77354-2877
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Country | US
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Telephone | 936-788-6493
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Fax | 844-705-0120
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Provider Business Mailing Address
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Address Line | 59 RUSH HAVEN DR
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City | THE WOODLANDS
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State | TX
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Zip | 77381-3229
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Country | US
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Telephone | 936-788-6493
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Fax | 844-705-0120
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Authorized Official
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Title or Position | FNP-C
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Name | KATHY JEAN GARVIN
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Credential |
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Telephone | 936-788-6493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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