Provider Demographics
NPI:1396379772
Name:HEIGHTS TOTAL WELLNESS CLINIC, PLLC
Entity Type:Organization
Organization Name:HEIGHTS TOTAL WELLNESS CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-305-9515
Mailing Address - Street 1:5000 ELDORADO PKWY
Mailing Address - Street 2:BOX 150-153
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-8695
Mailing Address - Country:US
Mailing Address - Phone:321-305-9515
Mailing Address - Fax:972-637-9272
Practice Address - Street 1:1801 DURHAM DR STE 4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2272
Practice Address - Country:US
Practice Address - Phone:800-246-5698
Practice Address - Fax:972-637-9272
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENS T CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-25
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty