Provider Demographics
NPI:1851673248
Name:WORKSITE WELLNESS, INC.
Entity type:Organization
Organization Name:WORKSITE WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-391-6489
Mailing Address - Street 1:3524 SERENDIPITY HILLS TRL
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3601
Mailing Address - Country:US
Mailing Address - Phone:940-391-6489
Mailing Address - Fax:940-497-2192
Practice Address - Street 1:3524 SERENDIPITY HILLS TRL
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-3601
Practice Address - Country:US
Practice Address - Phone:940-391-6489
Practice Address - Fax:940-497-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0913207Q00000X
TX576843163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty