Provider Demographics
NPI:1447724315
Name:TOTAL WELLNESS FAMILY CLINIC, LLC
Entity type:Organization
Organization Name:TOTAL WELLNESS FAMILY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-243-6104
Mailing Address - Street 1:2384 S DAIRY ASHFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5739
Mailing Address - Country:US
Mailing Address - Phone:832-243-6104
Mailing Address - Fax:832-917-0926
Practice Address - Street 1:2384 S DAIRY ASHFORD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5739
Practice Address - Country:US
Practice Address - Phone:832-243-6104
Practice Address - Fax:832-917-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1083088090OtherNPI