Skinique Med Spa & Wellness

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

SKINIQUE MED SPA & WELLNESS

Practice address

3160 N Tarrant Pkwy Ste 404
Fort Worth, TX 76177-8614

Phone

(817) 484-0300

NPI assigned

Jul 31, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mark Charlie Valente, D.O.

Title

Manager

Phone

(817) 484-0300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1215313259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 N TARRANT PKWY STE 404",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778614",
            "telephone_number": "817-484-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 N TARRANT PKWY STE 404",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778614",
            "telephone_number": "817-484-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINIQUE MED SPA & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "VALENTE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CHARLIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-484-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Skiba, D.O.
• Mindy Skidmore
• Steven Leo Skiles, P.A.-C.
• Christopher Don Skillern, MD
• Katy Weischwill Skillman, M.S., CCC-SLP
• Kevin Skinner, LPC
• Phillip Howard Skinner, MD
• Quinn Skinner
• John Anthony Sklar, M.D.
• Katherine Nicole Skodak, PA-C

• Nutrition Education Nutritionist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Nutrition Education Nutritionist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.