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General NPI Number Information
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NPI Number | 1851411201
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS WELLNESS CENTERS LLC
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 3003 SOUTH LOOP W STE 415
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City | HOUSTON
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State | TX
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Zip | 77054-1301
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Country | US
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Telephone | 713-839-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 SOUTH LOOP W STE 415
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City | HOUSTON
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State | TX
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Zip | 77054-1301
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Country | US
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Telephone | 713-839-9355
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Fax |
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Authorized Official
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Title or Position | D.O.
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Name | PLESHETTE B JOHNSON
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Credential | D.O.
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Telephone | 713-839-9355
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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