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General NPI Number Information
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NPI Number | 1174762561
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Entity Type | Organization
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Legal Business Name | WELLNESS ASSOCIATES OF KATY, LLC
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 777 S FRY RD SUITE 105
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City | KATY
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State | TX
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Zip | 77450-2244
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Country | US
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Telephone | 281-647-9950
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Fax | 281-647-9960
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Provider Business Mailing Address
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Address Line | 777 S FRY RD SUITE 105
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City | KATY
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State | TX
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Zip | 77450-2244
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Country | US
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Telephone | 281-647-9950
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Fax | 281-647-9960
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Authorized Official
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Title or Position | LLC MEMBER
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Name | ARLENE M LOESCHEN
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Credential | NP
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Telephone | 281-647-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 578962
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | J9021
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License Number State | TX
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