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General NPI Number Information
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NPI Number | 1568176279
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Entity Type | Organization
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Legal Business Name | BOTANY WELLNESS, PLLC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 3129 KINGSLEY DR STE 610
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City | PEARLAND
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State | TX
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Zip | 77584-8508
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Country | US
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Telephone | 832-987-3352
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Fax | 832-281-0853
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Provider Business Mailing Address
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Address Line | 3129 KINGSLEY DR STE 610
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City | PEARLAND
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State | TX
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Zip | 77584-8508
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Country | US
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Telephone | 832-987-3352
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Fax | 832-281-0853
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER A UKWU
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Credential | MD
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Telephone | 469-583-6167
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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 |
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License Number State |
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