Provider Demographics
NPI:1760552780
Name:WEST UNIVERSITY WELLNESS, P.C.
Entity Type:Organization
Organization Name:WEST UNIVERSITY WELLNESS, P.C.
Other - Org Name:WEST U WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCISCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-490-2225
Mailing Address - Street 1:5180 BUFFALO SPEEDWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4215
Mailing Address - Country:US
Mailing Address - Phone:713-490-2225
Mailing Address - Fax:713-490-2226
Practice Address - Street 1:5180 BUFFALO SPEEDWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4215
Practice Address - Country:US
Practice Address - Phone:713-490-2225
Practice Address - Fax:713-490-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF006456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00615WMedicare PIN