Provider Demographics
NPI:1144645409
Name:TARGET HEALTH AND WELLNESS
Entity type:Organization
Organization Name:TARGET HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN LIAISON
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-906-7634
Mailing Address - Street 1:6565 WEST LOOP S STE 300
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3505
Mailing Address - Country:US
Mailing Address - Phone:713-906-7634
Mailing Address - Fax:832-213-3070
Practice Address - Street 1:6565 WEST LOOP S STE 300
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3505
Practice Address - Country:US
Practice Address - Phone:713-906-7634
Practice Address - Fax:832-213-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty