ULTIMATE WELLNESS PROVIDERS CO NPI 1710408448

NPI Information

NPI: 1710408448
Provider Name: ULTIMATE WELLNESS PROVIDERS CO
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
3203 KELLING STREET
HOUSTON, TX
ZIP 77045
Phone: (832) 705-5360
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ULTIMATE WELLNESS PROVIDERS CO is a health service clinic center in Houston, TX. ULTIMATE WELLNESS PROVIDERS CO NPI is 1710408448. The provider is registered as an organization entity type.

The provider's business location address is:

3203 KELLING STREET
HOUSTON, TX
ZIP 77045
Phone: (832) 705-5360

The provider's authorized official is Lasonja Malone .
The authorized official title is Ceo/owner and has the following contact phone number (832) 705-5360.

The enumeration date for this NPI number is 7/3/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service		LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1366970394	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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