Provider Demographics
NPI:1629687728
Name:TEXAS FAMILY WELLNESS CLINIC, INC.
Entity Type:Organization
Organization Name:TEXAS FAMILY WELLNESS CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:GUEVARA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-933-1188
Mailing Address - Street 1:15406 NORTHWEST BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-5865
Mailing Address - Country:US
Mailing Address - Phone:361-933-1188
Mailing Address - Fax:361-933-5011
Practice Address - Street 1:15406 NORTHWEST BLVD STE B
Practice Address - Street 2:
Practice Address - City:ROBSTOWN
Practice Address - State:TX
Practice Address - Zip Code:78380-5865
Practice Address - Country:US
Practice Address - Phone:361-205-9677
Practice Address - Fax:361-933-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty