Provider Demographics
NPI:1285005033
Name:UNIQUE SPA AND HEALTH CENTER
Entity Type:Organization
Organization Name:UNIQUE SPA AND HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REIDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-584-3480
Mailing Address - Street 1:1779 WELLS BRANCH PWKY
Mailing Address - Street 2:NUMBER 110B-323
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728
Mailing Address - Country:US
Mailing Address - Phone:512-584-3480
Mailing Address - Fax:512-990-7980
Practice Address - Street 1:1779 WELLS BRANCH PWKY
Practice Address - Street 2:NUMBER 110B-323
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728
Practice Address - Country:US
Practice Address - Phone:512-584-3480
Practice Address - Fax:512-990-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service