Provider Demographics
NPI:1891333753
Name:MIND BODY WELLNESS SOLUTIONS
Entity Type:Organization
Organization Name:MIND BODY WELLNESS SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, FNP
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-844-8866
Mailing Address - Street 1:3408 SAM HOUSTON DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2238
Mailing Address - Country:US
Mailing Address - Phone:361-844-8866
Mailing Address - Fax:361-894-6064
Practice Address - Street 1:3408 SAM HOUSTON DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2238
Practice Address - Country:US
Practice Address - Phone:361-844-8866
Practice Address - Fax:361-894-6064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1003044330OtherNPI NUMBER