MEDICARE: SUMMIT WELLNESS OF TEXAS

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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1710836432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT WELLNESS OF TEXAS

Provider Business Mailing Address
First Line	:	2329 EDENBORN AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-1815
Country	:	US
Telephone Number	:	504-571-5355
Fax Number	:

Provider Business Practice Location Address
First Line	:	7616 BRANFORD PL STE 220
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3794
Country	:	US
Telephone Number	:	281-815-8580
Fax Number	:	888-830-8403

Authorized Official
Title or Position	:	COO
Name	:	NICK GWYN
Credential	:
Telephone Number	:	281-815-8580

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “SUMMIT WELLNESS OF TEXAS ” Practice Location

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