Provider Demographics
NPI:1962783258
Name:ACTION HEALTHCARE & WELLNESS
Entity type:Organization
Organization Name:ACTION HEALTHCARE & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-812-3044
Mailing Address - Street 1:210 N. PARK BLVD.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-6986
Mailing Address - Country:US
Mailing Address - Phone:817-812-3044
Mailing Address - Fax:817-796-1378
Practice Address - Street 1:210 N PARK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6985
Practice Address - Country:US
Practice Address - Phone:817-812-3044
Practice Address - Fax:817-796-1378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX4202111N00000X
TXK9102208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty