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General NPI Number Information
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NPI Number | 1477765386
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Entity Type | Organization
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Legal Business Name | ZOE LIFE WELLNESS CENTER, PA
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 1601 MAIN ST SUITE 502
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City | RICHMOND
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State | TX
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Zip | 77469-3247
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Country | US
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Telephone | 281-238-5433
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Fax | 281-239-0235
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Provider Business Mailing Address
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Address Line | PO BOX 881
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City | RICHMOND
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State | TX
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Zip | 77406-0023
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Country | US
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Telephone | 281-238-5433
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Fax | 281-239-0235
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Authorized Official
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Title or Position | OWNER
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Name | DR. LETOSHA EVETTE GALE
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Credential | M.D.
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Telephone | 281-238-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K8624
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License Number State | TX
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