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General NPI Number Information
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NPI Number | 1548544331
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Entity Type | Organization
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Legal Business Name | ROPHE WELLNESS INC.
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 1201 E MADDOX AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-5746
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Country | US
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Telephone | 817-999-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 ENGBLAD DR
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City | FORT WORTH
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State | TX
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Zip | 76134-2311
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Country | US
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Telephone | 817-999-3880
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MRS. TINA LOUISA DAWSON
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Credential |
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Telephone | 817-999-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 801029495
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License Number State | TX
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