Provider Demographics
NPI:1184351157
Name:THE WELLNESS CENTER OF SAN ANTONIO, PLLC
Entity type:Organization
Organization Name:THE WELLNESS CENTER OF SAN ANTONIO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:CRAVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:210-334-7180
Mailing Address - Street 1:14222 CANARY LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-1213
Mailing Address - Country:US
Mailing Address - Phone:210-334-7180
Mailing Address - Fax:210-547-2050
Practice Address - Street 1:21518 BLANCO RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-3380
Practice Address - Country:US
Practice Address - Phone:210-334-7180
Practice Address - Fax:210-547-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty