Provider Demographics
NPI:1891205217
Name:TOMMY L. POOL, II
Entity Type:Organization
Organization Name:TOMMY L. POOL, II
Other - Org Name:HOLISTIC WELLNESS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:POOL
Authorized Official - Suffix:II
Authorized Official - Credentials:LPC, LCDC, SAP
Authorized Official - Phone:432-653-4981
Mailing Address - Street 1:1205 W UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79764-7119
Mailing Address - Country:US
Mailing Address - Phone:432-653-4981
Mailing Address - Fax:877-614-6254
Practice Address - Street 1:1205 W UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79764-7119
Practice Address - Country:US
Practice Address - Phone:432-653-4981
Practice Address - Fax:877-614-6254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65821261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10857OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES