Provider Demographics
NPI:1013751650
Name:PRECISION MIND AND BODY
Entity type:Organization
Organization Name:PRECISION MIND AND BODY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GUKHOOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-201-4150
Mailing Address - Street 1:1535 FM 646 RD W
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-3395
Mailing Address - Country:US
Mailing Address - Phone:281-201-4150
Mailing Address - Fax:
Practice Address - Street 1:1535 FM 646 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3395
Practice Address - Country:US
Practice Address - Phone:281-201-4150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty