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General NPI Number Information
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NPI Number | 1770318917
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Entity Type | Organization
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Legal Business Name | WELLNESSWITS INC
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 9214 LAKESHORES LAGOON
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City | CYPRESS
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State | TX
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Zip | 77433-6810
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Country | US
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Telephone | 832-779-2347
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Fax |
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Provider Business Mailing Address
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Address Line | 9214 LAKESHORES LAGOON
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City | CYPRESS
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State | TX
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Zip | 77433-6810
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Country | US
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Telephone | 832-779-2347
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KIKE ODUBA
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Credential | MD
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Telephone | 832-779-2347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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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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