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General NPI Number Information
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NPI Number | 1609575703
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Entity Type | Organization
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Legal Business Name | THE WELLNESS DOC INTEGRATIVE MEDICINE, PLLC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 2636 S LOOP W STE 105
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City | HOUSTON
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State | TX
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Zip | 77054-2402
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Country | US
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Telephone | 832-844-1754
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Fax |
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Provider Business Mailing Address
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Address Line | 2636 S LOOP W STE 105
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City | HOUSTON
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State | TX
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Zip | 77054-2402
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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 | ALEXIA MCCLERKIN
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Credential | NP
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Telephone | 832-844-1754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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