Cosmedic Wellness Centers, Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

COSMEDIC WELLNESS CENTERS, INC

Practice address

1030 E Hwy 377 Ste 114
Granbury, TX 76048-1457

Phone

(817) 579-2660

Fax

(877) 465-6014

NPI assigned

Dec 26, 2018

Organization subpart

Yes

Parent organization

COSMEDIC WELLNESS CENTERS, INCAs reported in NPPES

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

Authorized official

Name

Kelly Christine Krepinevich

Title

Business Manager

Phone

(817) 579-2660

Specialties & licenses 1

Addresses

Other names 1

• Elite Med Spa Doing business as

Part of

Cosmedic Wellness Cntrs Inc

Locations

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1053883405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E HWY 377 STE 114",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481457",
            "telephone_number": "817-579-2660",
            "fax_number": "877-456-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E HWY 377 STE 114",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481457",
            "telephone_number": "817-579-2660",
            "fax_number": "877-465-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMEDIC WELLNESS CENTERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSMEDIC WELLNESS CENTERS, INC",
        "enumeration_date": "2018-12-26",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "KREPINEVICH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "817-579-2660"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Med Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Ann Cooper, FNP-C
• Ronald D Cooper, DDS
• Jayme R Cornwell, DPM
• Coryell County Memorial Hospital Authority
• Julie Cosa
• Mary Ann Cotten, PH.D.
• Counseling by Penny
• Theresa Covington, MA, LPC
• Cowtown Headache Center and Neurodiagnostics, PLLC
• Nancy Cox

• Otolaryngology Physician in Granbury, TX
• Providers in Granbury, TX by specialty
• Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.