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General NPI Number Information
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NPI Number | 1396347514
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Entity Type | Organization
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Legal Business Name | KEN ADOLPH WELLNESS, LLC
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 2911 MEDICAL ARTS ST STE 19A
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City | AUSTIN
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State | TX
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Zip | 78705-3329
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Country | US
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Telephone | 512-686-5935
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Fax | 737-242-9997
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Provider Business Mailing Address
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Address Line | 2911 MEDICAL ARTS ST STE 19A
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City | AUSTIN
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State | TX
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Zip | 78705-3329
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Country | US
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Telephone | 512-585-9594
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Fax |
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Authorized Official
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Title or Position | FOUNDER/MEDICAL DIRECTOR
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Name | DR. HOWARD KENNETH ADOLPH
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Credential | MD
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Telephone | 512-750-1348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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