Provider Demographics
NPI:1699398693
Name:WELNOVA HEALTH, LLC
Entity Type:Organization
Organization Name:WELNOVA HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDLEBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-499-9100
Mailing Address - Street 1:5161 SAN FELIPE ST # 320-18
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3633
Mailing Address - Country:US
Mailing Address - Phone:713-497-1171
Mailing Address - Fax:
Practice Address - Street 1:5444 WESTHEIMER RD STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5318
Practice Address - Country:US
Practice Address - Phone:832-499-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service