Provider Demographics
NPI:1073328746
Name:WEST TEXAS HEALTH AND WELLNESS DBA AESTHETICALLY UNIQUE
Entity type:Organization
Organization Name:WEST TEXAS HEALTH AND WELLNESS DBA AESTHETICALLY UNIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ FAMILY PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PARKE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:915-600-0933
Mailing Address - Street 1:3100 N YARBROUGH DR. PO BOX 370055.
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-9998
Mailing Address - Country:US
Mailing Address - Phone:915-600-0933
Mailing Address - Fax:
Practice Address - Street 1:10105 GARWOOD CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7301
Practice Address - Country:US
Practice Address - Phone:915-600-0933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST TEXAS HEALTH AND WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center