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General NPI Number Information
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NPI Number | 1831341452
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Entity Type | Organization
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Legal Business Name | HOPE WELLNESS CLINIC
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 8240 ANTOINE DR SUITE 107
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City | HOUSTON
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State | TX
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Zip | 77088-2534
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Country | US
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Telephone | 281-447-5570
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Fax | 281-447-5598
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Provider Business Mailing Address
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Address Line | 723 SHOTWELL ST B
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City | HOUSTON
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State | TX
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Zip | 77020-4813
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Country | US
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Telephone | 713-673-9400
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Fax | 713-673-9401
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAMIEN BROUGH SANDERLIN
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Credential | M.D.
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Telephone | 281-447-5570
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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 | L6617
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License Number State | TX
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