Provider Demographics
NPI:1982214375
Name:HIPPOMED WELLNESS CLINICS LIMITED COMPANY
Entity Type:Organization
Organization Name:HIPPOMED WELLNESS CLINICS LIMITED COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-709-6790
Mailing Address - Street 1:5930 LBJ FWY STE 380
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6370
Mailing Address - Country:US
Mailing Address - Phone:972-803-6008
Mailing Address - Fax:469-460-6558
Practice Address - Street 1:5930 LBJ FWY STE 380
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6370
Practice Address - Country:US
Practice Address - Phone:972-803-6008
Practice Address - Fax:469-460-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty