Provider Demographics
NPI:1801613997
Name:THE WELL361 PLLC
Entity type:Organization
Organization Name:THE WELL361 PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEANDA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:361-877-4038
Mailing Address - Street 1:6262 WEBER RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4006
Mailing Address - Country:US
Mailing Address - Phone:361-877-4038
Mailing Address - Fax:
Practice Address - Street 1:6262 WEBER RD STE 202
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4006
Practice Address - Country:US
Practice Address - Phone:361-877-4038
Practice Address - Fax:361-299-5384
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAYLA DEANDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-20
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty