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NPI Code Detail

MEDICARE: VECABA WELLNESS, LLC

MEDICARE: VECABA WELLNESS, LLC
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
1111N00000XChiropractor
2261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1134604473
Entity Type Code : Organization
Provider Name (Legal Business Name) : VECABA WELLNESS, LLC
Provider Business Mailing Address
First Line : 1510 WAVECREST LN
Second Line :
City : HOUSTON
State : TX
Zip : 77062-5428
Country : US
Telephone Number : 541-554-1751
Fax Number :
Provider Business Practice Location Address
First Line : 16626 SEA LARK RD
Second Line :
City : HOUSTON
State : TX
Zip : 77062-5819
Country : US
Telephone Number : 541-554-1751
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. VENESSA BARTHOLOMEW
Credential : DC
Telephone Number : 541-554-1751
Provider Enumeration Date : 10/02/2018
Last Update Date : 10/31/2018

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