MEDICARE: LMB WELLNESS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1073250585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LMB WELLNESS SERVICES

Provider Business Mailing Address
First Line	:	2910 ASHLYN ARBOR DR
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-2151
Country	:	US
Telephone Number	:	346-360-8423
Fax Number	:

Provider Business Practice Location Address
First Line	:	18722 UNIVERSITY BLVD
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7213
Country	:	US
Telephone Number	:	346-360-8423
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LETICIA BHOLA
Credential	:	LCSW-S
Telephone Number	:	346-360-8423

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	03/02/2026

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