Provider Demographics
NPI:1427583020
Name:VICTORIOUS WELLNESS CENTER
Entity Type:Organization
Organization Name:VICTORIOUS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRALYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-791-3295
Mailing Address - Street 1:7035 W TIDWELL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2030
Mailing Address - Country:US
Mailing Address - Phone:832-791-3295
Mailing Address - Fax:832-413-0517
Practice Address - Street 1:7015 W TIDWELL RD STE 107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-2028
Practice Address - Country:US
Practice Address - Phone:832-791-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X
TXAP125837261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251J00000XAgenciesNursing Care