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General NPI Number Information
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NPI Number | 1790274462
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Entity Type | Organization
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Legal Business Name | ANEW WELLNESS, LLC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 1005 NEDERLAND AVE
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City | NEDERLAND
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State | TX
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Zip | 77627
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Country | US
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Telephone | 409-344-9935
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 NEDERLAND AVE
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City | NEDERLAND
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State | TX
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Zip | 77627-2832
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Country | US
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Telephone | 409-344-9935
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY MORGAN
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Credential |
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Telephone | 409-344-9935
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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 | K7946
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License Number State | TX
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