Provider Demographics
NPI:1730571175
Name:NORTHWEST HOUSTON WELLNESS CENTER
Entity type:Organization
Organization Name:NORTHWEST HOUSTON WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RASCHELL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPILLERS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:512-909-7888
Mailing Address - Street 1:3995 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3505
Mailing Address - Country:US
Mailing Address - Phone:512-909-7888
Mailing Address - Fax:
Practice Address - Street 1:3995 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3505
Practice Address - Country:US
Practice Address - Phone:512-909-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QE0700X, 261QF0050X, 261QH0100X, 261QI0500X, 261QP3300X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain