Provider Demographics
NPI:1851415020
Name:HEALTH & WELLNESS CLINIC, PA
Entity Type:Organization
Organization Name:HEALTH & WELLNESS CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD-RABIA
Authorized Official - Middle Name:SULAIMAN
Authorized Official - Last Name:AL-KHUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-665-8498
Mailing Address - Street 1:23920 KATY FWY STE 550
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0883
Mailing Address - Country:US
Mailing Address - Phone:281-665-8498
Mailing Address - Fax:
Practice Address - Street 1:23920 KATY FWY STE 550
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0883
Practice Address - Country:US
Practice Address - Phone:281-665-8498
Practice Address - Fax:281-665-8503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2086207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154488401Medicaid
TX154488401Medicaid
TX00712TMedicare PIN