Provider Demographics
NPI:1376919803
Name:VAX-A-NATION WELLNESS CLINICS LLC.
Entity Type:Organization
Organization Name:VAX-A-NATION WELLNESS CLINICS LLC.
Other - Org Name:VACCINE AND PREVENTION SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BARNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-460-9003
Mailing Address - Street 1:14655 NORTHWEST FWY
Mailing Address - Street 2:#101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-4042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14655 NORTHWEST FWY
Practice Address - Street 2:#101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-4042
Practice Address - Country:US
Practice Address - Phone:832-460-9003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316801501(02)Medicaid
TX316801501(02)Medicaid