Provider Demographics
NPI:1346614427
Name:ENVISION WELLNESS CENTRE
Entity type:Organization
Organization Name:ENVISION WELLNESS CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGCAID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-687-0082
Mailing Address - Street 1:17629 EL CAMINO REAL
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2901
Mailing Address - Country:US
Mailing Address - Phone:281-486-7044
Mailing Address - Fax:281-674-8443
Practice Address - Street 1:17629 EL CAMINO REAL
Practice Address - Street 2:SUITE 160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2901
Practice Address - Country:US
Practice Address - Phone:281-486-7044
Practice Address - Fax:281-674-8443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty