ESSENTIAL BODY BAR, PLLC


Address: 5751 Blythwood Street, Suite 200, Houston, TX 77021
Phone: 8328080903

ESSENTIAL BODY BAR, PLLC (NPI# 1821625815) 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) 1821625815
Entity Type Organization
Organization Name ESSENTIAL BODY BAR, PLLC
Practice Address 5751 Blythwood Street
Suite 200
Houston
TX 77021
Practice Telephone 8328080903
Practice Fax Number 8325537762
Mailing Telephone 8328080903
Mailing Fax Number 8325537762
Enumeration Date 2020-03-27
Last Update Date 2020-03-27
Authorized Official Name LETRICE KAY MASON (NURSE PRACTITIONER/OWNER)
Authorized Official Telephone 8178745505
Authorized Official Credential NP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 5751 BLYTHWOOD STREET
SUITE 200
City HOUSTON
State TX
Zip Code 77021

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1104426311 Erin Krim Gordon Nurse Practitioner 2202 Quenby St, Houston, TX 77005-1502 2020-10-27
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Competitor

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City HOUSTON
Zip Code 77021

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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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