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General NPI Number Information
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NPI Number | 1477361194
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Entity Type | Organization
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Legal Business Name | WELLNESS SYNERGY LLC
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 3311 NORMANDY FOREST CT
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City | SPRING
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State | TX
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Zip | 77388-5184
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Country | US
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Telephone | 346-525-6279
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Fax |
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Provider Business Mailing Address
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Address Line | 3311 NORMANDY FOREST CT
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City | SPRING
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State | TX
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Zip | 77388-5184
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Country | US
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Telephone | 832-832-0594
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ILKA TAMAR CANDELARIO
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Credential |
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Telephone | 832-832-0594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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