MEDICARE: THE WELLNESS ASSOCIATES OF HOUSTON, 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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1750577375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WELLNESS ASSOCIATES OF HOUSTON, INC.

Provider Business Mailing Address
First Line	:	440 BENMAR DR STE 2230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3169
Country	:	US
Telephone Number	:	281-999-5220
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 BENMAR DR STE 2230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3169
Country	:	US
Telephone Number	:	281-999-5220
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. MICHELLE MOUTON
Credential	:
Telephone Number	:	281-999-5220

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	09/18/2007

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