Provider Demographics
NPI:1851585939
Name:MIND BODYWORKERS INC.
Entity Type:Organization
Organization Name:MIND BODYWORKERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JARRETT
Authorized Official - Last Name:PFEIL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:409-762-6463
Mailing Address - Street 1:4920 SEAWALL BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-6011
Mailing Address - Country:US
Mailing Address - Phone:409-762-6463
Mailing Address - Fax:
Practice Address - Street 1:4920 SEAWALL BLVD STE D
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-6011
Practice Address - Country:US
Practice Address - Phone:409-762-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1490106H00000X
TXJ6659261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty