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General NPI Number Information
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NPI Number | 1184937526
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Entity Type | Organization
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Legal Business Name | MODERN WELLNESS AND HEALTH CENTER
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 08/02/2010
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Provider Practice Location Address
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Address Line | 12230 WESTHEIMER RD SUITE 85
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City | HOUSTON
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State | TX
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Zip | 77077-6043
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Country | US
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Telephone | 832-379-8000
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Fax | 832-379-8001
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Provider Business Mailing Address
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Address Line | 12230 WESTHEIMER RD SUITE 85
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City | HOUSTON
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State | TX
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Zip | 77077-6043
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Country | US
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Telephone | 832-379-8000
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Fax | 832-379-8001
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Authorized Official
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Title or Position | PARTNER
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Name | DR. UZZIAH P GRIGSBY III
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Credential | D.C.
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Telephone | 832-379-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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