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General NPI Number Information
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NPI Number | 1952221756
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Entity Type | Organization
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Legal Business Name | WELLNESS REVOLUTION TEXAS LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 10450 SPRING GREEN BLVD STE B
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City | KATY
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State | TX
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Zip | 77494-5909
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Country | US
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Telephone | 281-606-0905
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Fax | 281-936-0308
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Provider Business Mailing Address
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Address Line | 10450 SPRING GREEN BLVD STE B
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City | KATY
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State | TX
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Zip | 77494-5909
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Country | US
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Telephone | 281-606-0905
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Fax | 281-936-0308
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | NIKI GARDNER
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Credential |
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Telephone | 281-606-0905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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