R2 Well Practice Management
Preventive Medicine, Public Health & General Preventive Medicine in Euless, TX. Organization (NPI-2).
NPI number1235643149
StatusActive
Last updated in NPPESNov 30, 2017
Details
- NPI
- 1235643149
- Entity type
- Organization (NPI-2)
- Legal business name
- R2 Well Practice Management
- Organization subpart
- No
- Enumeration date
- Nov 30, 2017
- Last updated
- Nov 30, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | G0723 | TX | Yes |
Practice location
451 Westpark Way Ste 5Euless, TX 76040-3703
Phone 817-571-6505
Mailing address
451 Westpark Way Ste 5Euless, TX 76040-3703
Phone 817-571-6505
Authorized official
Johnette Van Eeden
Ceo
8175716505
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