Diabetes Wellness Clinic PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

L6339 Issued in TX

Legal business name

DIABETES WELLNESS CLINIC PLLC

Practice address

10970 Shadow Creek Pkwy Ste 260
Pearland, TX 77584-0121

Phone

(832) 524-4043

Fax

(832) 524-4043

NPI assigned

Sep 23, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Timothy Dilon Daniel, MD

Title

Physician/President

Phone

(832) 524-4043

Specialties & licenses 1

Addresses

Other names 1

• Diabetes Wellness Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506124800000",
    "number": "1003325960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11404 MISTY MORNING ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775848374",
            "telephone_number": "832-524-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10970 SHADOW CREEK PKWY STE 260",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775840121",
            "telephone_number": "832-524-4043",
            "fax_number": "832-524-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-23",
        "last_updated": "2017-09-23",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DILON",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "832-524-4043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "L6339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetes Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Specialty Clinic/Center in Pearland, TX
• Providers in Pearland, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.