Provider Demographics
NPI:1720586753
Name:SUNRISE HEALTH AND WELLNESS PLLC
Entity Type:Organization
Organization Name:SUNRISE HEALTH AND WELLNESS PLLC
Other - Org Name:SUNRISE FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAYSHALEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:281-812-3990
Mailing Address - Street 1:6725 ATASCOCITA RD STE A
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2292
Mailing Address - Country:US
Mailing Address - Phone:281-812-3990
Mailing Address - Fax:
Practice Address - Street 1:6725 ATASCOCITA RD STE A
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346
Practice Address - Country:US
Practice Address - Phone:915-544-0086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty