Provider Demographics
NPI:1053184606
Name:DD'S WELLNESS AND MEDICAL CENTER LLC
Entity type:Organization
Organization Name:DD'S WELLNESS AND MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:IHEOMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHUKWUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-517-5848
Mailing Address - Street 1:3310 HIGHWAY 6 S STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3149
Mailing Address - Country:US
Mailing Address - Phone:678-517-5848
Mailing Address - Fax:281-670-5187
Practice Address - Street 1:3310 HIGHWAY 6 S STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3149
Practice Address - Country:US
Practice Address - Phone:678-517-5848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty