Provider Demographics
NPI:1649066853
Name:AMA'ARI WELLNESS CLINIC LLC
Entity type:Organization
Organization Name:AMA'ARI WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:EJIRO
Authorized Official - Last Name:MADUEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:281-710-5232
Mailing Address - Street 1:3634 GLENN LAKES LN STE 198
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4062
Mailing Address - Country:US
Mailing Address - Phone:281-710-5232
Mailing Address - Fax:
Practice Address - Street 1:3634 GLENN LAKES LN STE 198
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4062
Practice Address - Country:US
Practice Address - Phone:281-710-5232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center