Provider Demographics
NPI:1982827911
Name:INNOVATIVE HEALTH INC.
Entity Type:Organization
Organization Name:INNOVATIVE HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ATHALIE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-407-9355
Mailing Address - Street 1:1408 W KOENIG LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1426
Mailing Address - Country:US
Mailing Address - Phone:512-407-9355
Mailing Address - Fax:512-302-4250
Practice Address - Street 1:1408 W KOENIG LN
Practice Address - Street 2:SUITE C
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1426
Practice Address - Country:US
Practice Address - Phone:512-407-9355
Practice Address - Fax:512-302-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5925111N00000X
TX103021225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ74XOtherBCBS GROUP #