KETAMINE WELLNESS CENTERS HOUSTON, LLC (NPI# 1861008831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861008831 |
| Entity Type | Organization |
| Organization Name | KETAMINE WELLNESS CENTERS HOUSTON, LLC |
| Other Organization Name | KETAMINE WELLNESS CENTERS |
| Practice Address |
12807 Haynes Rd Unit 1 Houston TX 77066-1124 |
| Practice Telephone | 8555389355 |
| Practice Fax Number | 8445389355 |
| Mailing Telephone | 8555389355 |
| Mailing Fax Number | 8445389355 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | MS. ANITA JERGER (EXECUTIVE ASSISTANT) |
| Authorized Official Telephone | 8555389355 |
| Is Organization Subpart | Y |
| Parent Organization Name | KETAMINE WELLNESS CENTERS ARIZONA LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ketamine Wellness Centers | Doing Business As Name - Organization |
| Street Address |
12807 HAYNES RD UNIT 1 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77066-1124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184289886 | Ashley Watley | Occupational Therapy Assistant | 4710 Sabrina Drive, Houston, TX 77066 | 2019-05-08 |
| 1275025850 | Angela Buie | Phlebology | 5907 Queensgate Dr., Hse, Houston, TX 77066 | 2018-05-31 |
| 1285906974 | Thuy Thi Tran | Pharmacist | 12702 Bammel-north Houston, Houston, TX 77066 | 2012-01-27 |
| 1548562457 | Luv-n-joi At Home Care | Home Health | 11423 Weathering Oaks Drive, Houston, TX 77066 | 2010-11-29 |
| 1003130568 | Axis Ems Services Inc | Ambulance | 11426 Courtcliff, Houston, TX 77066 | 2010-03-26 |
| 1275701096 | Alicia Renee Green - Scott | Counselor | 2902 Milroy Lane, Houston, TX 77066 | 2008-02-14 |
| 1447270756 | After Care Ambulance Transfer Inc | Ambulance | 13940 Bammel N Houston, #223, Houston, TX 77066 | 2006-07-20 |
| 1720047632 | Texas Medical & Mobility | Durable Medical Equipment & Medical Supplies | 7007 Belgold, Sui H, Houston, TX 77066 | 2006-03-20 |
| 1528555307 | Champions Point Family Clinic LLC | Clinic/Center | 5367 W Richey Rd, Houston, TX 77066 | 2018-04-17 |
| 1902999774 | Patricia Monette Williams | Counselor | 12902 Haynes Rd, Suite B, Houston, TX 77066 | 2006-10-02 |
| Find all providers in zip 77066 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346721834 | Interventional Pain and Wellness | Anesthesiology | 4543 Post Oak Place Dr Ste 123, Houston, TX 77027-3103 | 2018-08-23 |
| 1578058863 | Heights Diagnostics LLC | Anesthesiology | 11006 Landon Ln, Houston, TX 77024-5402 | 2018-06-28 |
| 1831699933 | Integrated Health and Pain Management Pllc | Anesthesiology | 1120 Nasa Pkwy Ste 220q, Houston, TX 77058-3342 | 2018-02-15 |
| 1922559988 | Foundation for Better Education | Anesthesiology | 3920 Braxton Dr Ste 110, Houston, TX 77063-6304 | 2016-10-14 |
| 1740645787 | Delta Spine and Pain Clinic Pa | Anesthesiology | 12000 Richmond Ave Ste 270, Houston, TX 77082-2431 | 2015-12-17 |
| 1093109167 | Colbert Pllc | Anesthesiology | 6121 Hillcroft St # 0, Houston, TX 77081-1002 | 2015-03-26 |
| 1053752428 | Gulf Coast Pain Specialists Pllc | Anesthesiology | 10930 Resource Pkwy Ste A, Houston, TX 77089-6157 | 2013-07-12 |
| 1063760858 | Saman Kohanof | Anesthesiology | 6431 Fannin St Ste 5196, Houston, TX 77030-1501 | 2012-08-27 |
| 1164778528 | Thuan Duc Dao | Anesthesiology | 9701 Richmond Ave Ste 220, Houston, TX 77042-4622 | 2012-08-02 |
| 1215293808 | Cole Andrew Fitzgerald | Anesthesiology | 13300 Hargrave Rd Ste 505, Houston, TX 77070-4374 | 2012-04-08 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.