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General NPI Number Information
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NPI Number | 1821533076
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Entity Type | Organization
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Legal Business Name | MENDER WELLNESS
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 01/02/2017
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Provider Practice Location Address
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Address Line | 6260 WESTPARK DR 110
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City | HOUSTON
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State | TX
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Zip | 77057-7312
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Country | US
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Telephone | 713-334-5226
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Fax |
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Provider Business Mailing Address
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Address Line | 6260 WESTPARK DR 110
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City | HOUSTON
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State | TX
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Zip | 77057-7312
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Country | US
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Telephone | 713-334-5226
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ANDRE REID
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Credential |
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Telephone | 832-495-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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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 | 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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