Provider Demographics
NPI:1851803373
Name:PARIS WELLNESS CENTER & MEDICAL SPA
Entity Type:Organization
Organization Name:PARIS WELLNESS CENTER & MEDICAL SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:903-783-0500
Mailing Address - Street 1:1122 E. AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460
Mailing Address - Country:US
Mailing Address - Phone:903-783-0500
Mailing Address - Fax:903-783-1167
Practice Address - Street 1:1122 E. AUSTIN ST.
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460
Practice Address - Country:US
Practice Address - Phone:903-783-0500
Practice Address - Fax:903-783-1167
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMACK PRESTON FAMILY MEDICAL CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP113680207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Single Specialty