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General NPI Number Information
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NPI Number | 1265051809
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Entity Type | Organization
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Legal Business Name | WITTY HEALTH MEDICAL PA
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 5850 SAN FELIPE ST STE 500
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City | HOUSTON
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State | TX
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Zip | 77057-8003
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Country | US
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Telephone | 713-496-9264
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 SAN FELIPE ST STE 500
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City | HOUSTON
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State | TX
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Zip | 77057-8003
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Country | US
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Telephone | 713-496-9264
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | WHITNEY AHNEMAN
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Credential | MBA, RD, CDE
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Telephone | 203-550-1062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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