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General NPI Number Information
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NPI Number | 1407289820
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Entity Type | Organization
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Legal Business Name | WELLNESS INSTITUTE OF TEXAS
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 01/17/2014
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Provider Practice Location Address
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Address Line | 14855 BLANCO RD STE 400
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City | SAN ANTONIO
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State | TX
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Zip | 78216-7731
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Country | US
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Telephone | 210-641-3335
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Fax | 210-568-6101
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Provider Business Mailing Address
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Address Line | 14855 BLANCO RD STE 400
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City | SAN ANTONIO
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State | TX
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Zip | 78216-7731
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Country | US
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Telephone | 210-641-3335
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Fax | 210-568-6101
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | MRS. ROCHELE NICOLAS-WEDIGE
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Credential | APRN
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Telephone | 210-641-3335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 713314
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License Number State | TX
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