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General NPI Number Information
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NPI Number | 1427391762
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Entity Type | Organization
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Legal Business Name | X-PERT WELLNESS, PA
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 8989 WESTHEIMER RD #320
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City | HOUSTON
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State | TX
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Zip | 77063-3621
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Country | US
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Telephone | 713-772-7246
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Fax | 713-772-9657
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Provider Business Mailing Address
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Address Line | 3319 WILD RIV
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City | RICHMOND
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State | TX
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Zip | 77406-2488
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Country | US
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Telephone | 281-773-2758
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. AYO A AJIM
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Credential | MD
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Telephone | 281-773-2758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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