Organization Active NPI

Performance Health and Wellness PLLC

  • Chiropractor
  • Brenham, TX
National Provider Identifier
1124592456
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PERFORMANCE HEALTH AND WELLNESS PLLC
Practice address
306 E Main St
Brenham, TX 77833-3706
Phone
(979) 451-9111
Fax
(713) 456-2727
NPI assigned
Jan 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Authorized official

Name
Dr. Rheagan K Mulder, DCNPI 1124343322
Title
Owner
Phone
(979) 451-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

306 E Main St
Brenham, TX 77833-3706

Mailing address

306 E Main St
Brenham, TX 77833-3706
Phone (979) 451-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190321000957 TX Part B Supplier - Clinic/Group Practice 3678813045 Receives reassigned benefits from 1 practitioner
Practice locations: Brenham, TX

National Provider Directory

National Provider Directory

Locations

300 E Main St
Brenham, TX 77833
Phone (979) 451-9111

301 E Academy St
Brenham, TX 77833
Phone (979) 451-9111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548028800000",
    "number": "1124592456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E MAIN ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778333706",
            "telephone_number": "979-451-9111",
            "fax_number": "713-456-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAIN ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778333706",
            "telephone_number": "979-451-9111",
            "fax_number": "713-456-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE HEALTH AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A",
        "authorized_official_last_name": "MULDER",
        "authorized_official_first_name": "RHEAGAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-451-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.