Provider Demographics
NPI:1518621002
Name:AESTHETICS RX
Entity Type:Organization
Organization Name:AESTHETICS RX
Other - Org Name:WELLNESS RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KANEISHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:281-946-7283
Mailing Address - Street 1:5850 SAN FELIPE ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-8003
Mailing Address - Country:US
Mailing Address - Phone:281-946-7283
Mailing Address - Fax:281-828-0680
Practice Address - Street 1:5850 SAN FELIPE ST STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-8003
Practice Address - Country:US
Practice Address - Phone:281-946-7283
Practice Address - Fax:281-828-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty