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General NPI Number Information
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NPI Number | 1588486948
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Entity Type | Organization
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Legal Business Name | ALEXA SENIOR WELLNESS LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 6913 CULLEN BLVD STE B
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City | HOUSTON
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State | TX
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Zip | 77021-5009
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Country | US
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Telephone | 206-412-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 6913 CULLEN BLVD STE B
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City | HOUSTON
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State | TX
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Zip | 77021-5009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY MITCHELL
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Credential |
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Telephone | 206-412-4011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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