Provider Demographics
NPI:1457912677
Name:CORE HYDRATION AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:CORE HYDRATION AND WELLNESS, PLLC
Other - Org Name:CORE MENTAL HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKNER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, PMHNP-BC
Authorized Official - Phone:901-515-8347
Mailing Address - Street 1:16100 CAIRNWAY DR STE 235
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3500
Mailing Address - Country:US
Mailing Address - Phone:713-496-2069
Mailing Address - Fax:877-335-1881
Practice Address - Street 1:16100 CAIRNWAY DR STE 235
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3500
Practice Address - Country:US
Practice Address - Phone:713-496-2069
Practice Address - Fax:877-335-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356781538OtherPROVIDER