Provider Demographics
NPI:1144572769
Name:WELLNESS HEIGHTS, LLC
Entity Type:Organization
Organization Name:WELLNESS HEIGHTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:BUFFALOHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-668-5974
Mailing Address - Street 1:2136 YALE ST STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2528
Mailing Address - Country:US
Mailing Address - Phone:832-668-5974
Mailing Address - Fax:832-668-5984
Practice Address - Street 1:2136 YALE ST STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2528
Practice Address - Country:US
Practice Address - Phone:832-668-5974
Practice Address - Fax:832-668-5984
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESS HEIGHTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty