1245533595 NPI number — RELATIONSHIP FITNESS CENTER

Table of content: (NPI 1245533595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245533595 NPI number — RELATIONSHIP FITNESS CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RELATIONSHIP FITNESS CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE CHILDREN'S WELLNESS CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245533595
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
531 CRESTWATER CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77082-1517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-243-4901
Provider Business Mailing Address Fax Number:
832-243-4901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2630 FOUNTAIN VIEW DR
Provider Second Line Business Practice Location Address:
SUITE 375
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77057-7608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-278-1940
Provider Business Practice Location Address Fax Number:
832-243-4901
Provider Enumeration Date:
12/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
JUPITER
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CO-OWNER- DIRECTOR
Authorized Official Telephone Number:
281-905-5586

Provider Taxonomy Codes

  • Taxonomy code: 213EP1101X , with the licence number:  1959 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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