Provider Demographics
NPI:1902517790
Name:713 WELLNESS AND AESTHETICS CENTER
Entity Type:Organization
Organization Name:713 WELLNESS AND AESTHETICS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLINA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-693-5851
Mailing Address - Street 1:5911 HORSE PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1715
Mailing Address - Country:US
Mailing Address - Phone:832-693-5851
Mailing Address - Fax:
Practice Address - Street 1:2150 HIGHWAY 6 S STE 180
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4328
Practice Address - Country:US
Practice Address - Phone:832-693-5851
Practice Address - Fax:832-364-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty