MEDICARE: DEFINED WELLNESS 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
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1215891247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEFINED WELLNESS PLLC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR STE 25343
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	210-317-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 BALCONES DR STE 25343
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	210-317-0366
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	DIANA WHITE
Credential	:	AGACNP
Telephone Number	:	210-317-0366

Provider Enumeration Date	:	12/13/2025
Last Update Date	:	12/13/2025

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