Provider Demographics
NPI:1699661561
Name:SPINE WELLNESS CENTERS
Entity type:Organization
Organization Name:SPINE WELLNESS CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANDEFUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-362-0006
Mailing Address - Street 1:3101 COLLEGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4099
Mailing Address - Country:US
Mailing Address - Phone:281-362-0006
Mailing Address - Fax:281-362-0006
Practice Address - Street 1:3101 COLLEGE PARK DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4099
Practice Address - Country:US
Practice Address - Phone:281-362-0006
Practice Address - Fax:281-362-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty