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General NPI Number Information
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NPI Number | 1215781950
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Entity Type | Organization
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Legal Business Name | THERAWELL MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 05/05/2024
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Provider Practice Location Address
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Address Line | 23414 BAKER HILL DR
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City | RICHMOND
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State | TX
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Zip | 77469-2567
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Country | US
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Telephone | 346-613-0227
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Fax |
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Provider Business Mailing Address
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Address Line | 23414 BAKER HILL DR
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City | RICHMOND
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State | TX
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Zip | 77469-2567
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Country | US
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Telephone | 346-613-0227
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DORCAS AYANGA
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Credential | NP
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Telephone | 346-613-0227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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