Provider Demographics
NPI:1588204242
Name:NEXCARE WELLNESS CLINIC
Entity Type:Organization
Organization Name:NEXCARE WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JOULVOUS
Authorized Official - Middle Name:VENCIN
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:832-278-5558
Mailing Address - Street 1:PO BOX 2267
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-9267
Mailing Address - Country:US
Mailing Address - Phone:832-519-9339
Mailing Address - Fax:346-388-3014
Practice Address - Street 1:1935 TEXAS PKWY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3121
Practice Address - Country:US
Practice Address - Phone:832-519-9339
Practice Address - Fax:346-388-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty