Provider Demographics
NPI:1780898908
Name:THE WELLNESS CENTER FOR WOMEN P.A.
Entity type:Organization
Organization Name:THE WELLNESS CENTER FOR WOMEN P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:BRENNAN
Authorized Official - Last Name:REIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-283-4111
Mailing Address - Street 1:350 WESTPARK WAY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3958
Mailing Address - Country:US
Mailing Address - Phone:817-283-4111
Mailing Address - Fax:817-283-4550
Practice Address - Street 1:350 WESTPARK WAY
Practice Address - Street 2:SUITE 111
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3958
Practice Address - Country:US
Practice Address - Phone:817-283-4111
Practice Address - Fax:817-283-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1260207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20984Medicare UPIN