Provider Demographics
NPI:1831675396
Name:ENLIGHTENED WEIGH WELLNESS, INC
Entity Type:Organization
Organization Name:ENLIGHTENED WEIGH WELLNESS, INC
Other - Org Name:MEDI WEIGHTLOSS KATY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER/ FRANCHISEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-305-0735
Mailing Address - Street 1:22167 WESTHEIMER PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8301
Mailing Address - Country:US
Mailing Address - Phone:281-305-0735
Mailing Address - Fax:
Practice Address - Street 1:22167 WESTHEIMER PKWY STE 105
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8301
Practice Address - Country:US
Practice Address - Phone:281-305-0735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty