Provider Demographics
NPI:1225571334
Name:R & M WELLNESS PLLC
Entity Type:Organization
Organization Name:R & M WELLNESS PLLC
Other - Org Name:XPRESS FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYREAU
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C GNP-C RNFP
Authorized Official - Phone:903-871-2132
Mailing Address - Street 1:15632 STATE HIGHWAY 110 S STE 19
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5524
Mailing Address - Country:US
Mailing Address - Phone:903-871-2132
Mailing Address - Fax:903-871-2333
Practice Address - Street 1:15632 STATE HIGHWAY 110 S STE 19
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-5524
Practice Address - Country:US
Practice Address - Phone:903-871-2132
Practice Address - Fax:903-871-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP118711305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0200YMedicare UPIN