Provider Demographics
NPI:1821533076
Name:MENDER WELLNESS
Entity Type:Organization
Organization Name:MENDER WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-495-8080
Mailing Address - Street 1:6260 WESTPARK DR
Mailing Address - Street 2:110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7312
Mailing Address - Country:US
Mailing Address - Phone:713-334-5226
Mailing Address - Fax:
Practice Address - Street 1:6260 WESTPARK DR
Practice Address - Street 2:110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7312
Practice Address - Country:US
Practice Address - Phone:713-334-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain