Provider Demographics
NPI:1508435892
Name:DAVAM AESTHETICS AND WELLNESS PLLC
Entity Type:Organization
Organization Name:DAVAM AESTHETICS AND WELLNESS PLLC
Other - Org Name:DAVAM AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINOJOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-487-3031
Mailing Address - Street 1:PO BOX 8129
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5910 FM 1488 RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2515
Practice Address - Country:US
Practice Address - Phone:713-487-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty