Provider Demographics
NPI:1477185684
Name:NATURE HEALTH AND WELLNESS CLINIC LLC
Entity Type:Organization
Organization Name:NATURE HEALTH AND WELLNESS CLINIC LLC
Other - Org Name:WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ENAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:KASEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-910-3092
Mailing Address - Street 1:3569 BUSINESS CENTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1913
Mailing Address - Country:US
Mailing Address - Phone:713-360-6854
Mailing Address - Fax:
Practice Address - Street 1:3569 BUSINESS CENTER DR STE 160
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1914
Practice Address - Country:US
Practice Address - Phone:855-877-5977
Practice Address - Fax:832-603-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX419950701Medicaid