Provider Demographics
NPI:1346133253
Name:SUMMIT WELLNESS - NORTH TEXAS LLC
Entity type:Organization
Organization Name:SUMMIT WELLNESS - NORTH TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GWYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-250-5283
Mailing Address - Street 1:609 METAIRIE RD # 4014
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4034
Mailing Address - Country:US
Mailing Address - Phone:281-815-8580
Mailing Address - Fax:888-830-8403
Practice Address - Street 1:11133 SHADY TRL # 470
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-4617
Practice Address - Country:US
Practice Address - Phone:281-815-8580
Practice Address - Fax:888-830-8403
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT WELLNESS OF TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty