Provider Demographics
NPI:1437617545
Name:WELLNESS INSTITUTE OF NEURODEVELOPMENT
Entity Type:Organization
Organization Name:WELLNESS INSTITUTE OF NEURODEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAEZ-FRANCESCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-432-7004
Mailing Address - Street 1:5757 WOODWAY DR STE 190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-1526
Mailing Address - Country:US
Mailing Address - Phone:787-717-9279
Mailing Address - Fax:
Practice Address - Street 1:5757 WOODWAY DR STE 190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1526
Practice Address - Country:US
Practice Address - Phone:832-432-7004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities