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NPI Code Detail

MEDICARE: PREFERRED WELLNESS CENTER PLLC

MEDICARE: PREFERRED WELLNESS CENTER PLLC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1134406440
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED WELLNESS CENTER PLLC
Provider Business Mailing Address
First Line : 2506 W MOUNT HOUSTON RD
Second Line : SUITE H1
City : HOUSTON
State : TX
Zip : 77038-3518
Country : US
Telephone Number : 281-741-9159
Fax Number : 832-288-4260
Provider Business Practice Location Address
First Line : 2506 W MOUNT HOUSTON RD
Second Line : SUITE H1
City : HOUSTON
State : TX
Zip : 77038-3518
Country : US
Telephone Number : 281-741-9159
Fax Number : 832-288-4260
Authorized Official
Title or Position : DOCTOR
Name : DR. ROSA A FUENTES
Credential : M.D.
Telephone Number : 281-741-9159
Provider Enumeration Date : 11/15/2011
Last Update Date : 12/21/2011

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Directions to “PREFERRED WELLNESS CENTER PLLC ” Practice Location

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