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NPI Code Detail

MEDICARE: HI-ENERGY WEIGHT LOSS CENTERS OF TEXAS, INC.

MEDICARE: HI-ENERGY WEIGHT LOSS CENTERS OF TEXAS, INC.
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
1207Q00000XFamily Medicine PhysicianE4781TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11043277221OTHERTXNPI
21215094933OTHERTXNPI
31871868232OTHERTXNPI
41558612325OTHERTXNPI
51376654988OTHERTXNPI
61740308923OTHERTXNPI

General Provider Information

NPI Number : 1629433164
Entity Type Code : Organization
Provider Name (Legal Business Name) : HI-ENERGY WEIGHT LOSS CENTERS OF TEXAS, INC.
Provider Business Mailing Address
First Line : 2050 SHADY OAKS DR
Second Line :
City : SOUTHLAKE
State : TX
Zip : 76092-3510
Country : US
Telephone Number : 817-271-4154
Fax Number : 817-796-1595
Provider Business Practice Location Address
First Line : 1921 PRESTON RD
Second Line : #2008
City : PLANO
State : TX
Zip : 75093-5124
Country : US
Telephone Number : 972-381-9300
Fax Number : 972-381-9301
Authorized Official
Title or Position : PRESIDENT
Name : MR. STEPHEN JOEL OREN
Credential :
Telephone Number : 817-271-4154
Provider Enumeration Date : 12/29/2015
Last Update Date : 12/29/2015

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