1649998675 NPI number — WALTER J FAMILY AND WELLNESS CLINIC PLLC

Table of content: JANET HAYS (NPI 1255713251)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649998675 NPI number — WALTER J FAMILY AND WELLNESS CLINIC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALTER J FAMILY AND WELLNESS CLINIC PLLC
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:
Provider Other Organization Name Type Code:
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:
1649998675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9115 FM 723 RD STE 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77406-9235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-400-2118
Provider Business Mailing Address Fax Number:
832-400-2119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3129 KINGSLEY DR STE 1630
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-8510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-400-2118
Provider Business Practice Location Address Fax Number:
832-400-2119
Provider Enumeration Date:
08/16/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ONYECHEFUNA
Authorized Official First Name:
FAITH
Authorized Official Middle Name:
N.
Authorized Official Title or Position:
OWNER OF ENTITY
Authorized Official Telephone Number:
281-788-8103

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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