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NPI Code Detail

MEDICARE: SUMMIT WELLNESS - CENTRAL TEXAS LLC

MEDICARE: SUMMIT WELLNESS - CENTRAL TEXAS 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
1225700000XMassage Therapist

General Provider Information

NPI Number : 1265376370
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT WELLNESS - CENTRAL TEXAS LLC
Provider Business Mailing Address
First Line : 2329 EDENBORN AVE
Second Line :
City : METAIRIE
State : LA
Zip : 70001-1815
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1524 S INTERSTATE 35 STE 235
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2600
Country : US
Telephone Number : 512-547-1220
Fax Number : 888-830-8403
Authorized Official
Title or Position : CREDENTIALING
Name : AUSTIN DAILY
Credential :
Telephone Number : 504-571-5355
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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Directions to “SUMMIT WELLNESS - CENTRAL TEXAS LLC ” Practice Location

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