Provider Demographics
NPI:1598378432
Name:WOMEN'S HEALTH & FITNESS EXPO
Entity Type:Organization
Organization Name:WOMEN'S HEALTH & FITNESS EXPO
Other - Org Name:DISTRICT DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-502-2031
Mailing Address - Street 1:12510 FLEET RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-2210
Mailing Address - Country:US
Mailing Address - Phone:713-502-2031
Mailing Address - Fax:
Practice Address - Street 1:2715 SKYVIEW DOWNS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-6825
Practice Address - Country:US
Practice Address - Phone:713-502-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-29
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory