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General NPI Number Information
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NPI Number | 1639450018
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Entity Type | Organization
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Legal Business Name | MIND & BODY HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 2233 AVENUE J STE 101
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City | ARLINGTON
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State | TX
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Zip | 76006-5884
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Country | US
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Telephone | 817-460-7080
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Fax | 817-460-1220
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | ARLINGTON
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State | TX
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Zip | 76004-0487
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Country | US
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Telephone | 682-521-5700
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Fax | 817-460-1220
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GERMAINE BERNARD HAWKINS
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Credential | DO
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Telephone | 682-521-5700
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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 | 10856
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | L3329
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License Number State | TX
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