Provider Demographics
NPI:1326561440
Name:TEXAS WELLMED CLINIC, PLLC
Entity Type:Organization
Organization Name:TEXAS WELLMED CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-246-4668
Mailing Address - Street 1:12246 QUEENSTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5355
Mailing Address - Country:US
Mailing Address - Phone:281-246-4668
Mailing Address - Fax:832-862-5608
Practice Address - Street 1:12246 QUEENSTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5355
Practice Address - Country:US
Practice Address - Phone:281-246-4668
Practice Address - Fax:832-862-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty