| NPI | 1841063583 |
|---|---|
| Former Legal Business Name | INNOVATIVE WELLNESS MEDICAL CLINIC OF TEXAS LLC |
| Entity Type | Organization |
| Authorized Contact | MARIA E HERNANDEZ Site Director 346-569-6115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2025-06-18 |