Doctors Weight Loss Center & Wellness

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

736533 Issued in TX

Legal business name

DOCTORS WEIGHT LOSS CENTER & WELLNESS

Practice address

11215 S Interstate 35
Suite 114
Austin, TX 78747-1863

Phone

(512) 782-2084

Fax

(512) 782-2088

NPI assigned

Jul 5, 2013

Last updated

Jul 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Adys Mirabal, VICE PRESIDENT

Title

Managing Parner

Phone

(512) 782-2084

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1063852069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 S INTERSTATE 35",
            "address_2": "SUITE 114",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787471863",
            "telephone_number": "512-782-2084",
            "fax_number": "512-782-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 S INTERSTATE 35",
            "address_2": "SUITE 114",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787471863",
            "telephone_number": "512-782-2084",
            "fax_number": "512-782-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS WEIGHT LOSS CENTER & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "MIRABAL",
        "authorized_official_first_name": "ADYS",
        "authorized_official_title_or_position": "MANAGING PARNER",
        "authorized_official_telephone_number": "512-782-2084",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "VICE PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "736533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; 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.