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General NPI Number Information
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NPI Number | 1760718696
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Entity Type | Organization
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Legal Business Name | JR WELLNESS SERVICES, LLC
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 6859 S GESSNER DR
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City | HOUSTON
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State | TX
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Zip | 77036-4613
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Country | US
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Telephone | 713-981-6472
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Fax | 713-981-6478
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Provider Business Mailing Address
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Address Line | 6859 S GESSNER DR
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City | HOUSTON
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State | TX
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Zip | 77036-4613
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Country | US
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Telephone | 713-981-6472
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Fax | 713-981-6478
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. RICHARD P WILLIAMS JR.
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Credential | M.D.
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Telephone | 713-981-6472
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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 | D7887
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License Number State | TX
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