ULTIMATE WELLNESS PROVIDERS CO


Address: 3203 Kelling Street, Houston, TX 77045
Phone: (832) 705-5360

ULTIMATE WELLNESS PROVIDERS CO (NPI# 1710408448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710408448
Entity Type Organization
Organization Name ULTIMATE WELLNESS PROVIDERS CO
Practice Address 3203 Kelling Street
Houston
TX 77045
Mailing Address 3203 Kelling St
Houston
TX 77045-4346
Practice Telephone (832) 705-5360
Mailing Telephone 8327055360
Enumeration Date 2017-07-03
Last Update Date 2017-07-03
Authorized Official Name LASONJA MALONE (CEO/OWNER)
Authorized Official Telephone 8327055360
Authorized Official Credential CCMA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QH0100X Clinic/Center
Specialization: Health Service
LA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
LA 1366970394 05

Office Location

Street Address 3203 KELLING STREET
City HOUSTON
State TX
Zip Code 77045

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Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

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Competitor

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City HOUSTON
Zip Code 77045

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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