Provider Demographics
NPI:1588248389
Name:PRINCE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:PRINCE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:936-320-8740
Mailing Address - Street 1:PO BOX 130342
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-0342
Mailing Address - Country:US
Mailing Address - Phone:936-320-8740
Mailing Address - Fax:
Practice Address - Street 1:9004 FOREST XING STE C
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-1193
Practice Address - Country:US
Practice Address - Phone:936-320-8740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service