Provider Demographics
NPI:1487964870
Name:WELLNESS & CARE GROUP OF TEXAS, INC.
Entity type:Organization
Organization Name:WELLNESS & CARE GROUP OF TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:FARHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-417-3915
Mailing Address - Street 1:21175 TOMBALL PKWY # 504
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1655
Mailing Address - Country:US
Mailing Address - Phone:469-701-1770
Mailing Address - Fax:
Practice Address - Street 1:12600 ROLATER RD STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5188
Practice Address - Country:US
Practice Address - Phone:469-701-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB116512Medicare PIN