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General NPI Number Information
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NPI Number | 1376080770
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Entity Type | Organization
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Legal Business Name | REBALANCE WELLNESS CENTERS
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 3012 E HEBRON PKWY SUITE 116
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City | CARROLLTON
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State | TX
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Zip | 75010-4464
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Country | US
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Telephone | 214-200-4277
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Fax |
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Provider Business Mailing Address
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Address Line | 3012 E HEBRON PKWY SUITE 116
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City | CARROLLTON
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State | TX
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Zip | 75010-4464
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Country | US
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Telephone | 214-200-4277
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Fax |
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Authorized Official
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Title or Position | MD
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Name | CHRISTIAN MOYA
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Credential | MD
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Telephone | 214-200-4277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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