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General NPI Number Information
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NPI Number | 1457985251
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Entity Type | Organization
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Legal Business Name | IXI WELLNESS DALLAS LLC
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 10303 NORTHWEST FWY STE 263
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City | HOUSTON
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State | TX
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Zip | 77092-8299
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Country | US
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Telephone | 855-239-3554
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Fax |
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Provider Business Mailing Address
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Address Line | 10303 NORTHWEST FWY STE 263
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City | HOUSTON
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State | TX
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Zip | 77092-8299
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Country | US
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Telephone | 855-239-3554
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES STRADER
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Credential |
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Telephone | 512-739-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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