Teravista Family Wellness, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9952 Issued in TX

Legal business name

TERAVISTA FAMILY WELLNESS, PLLC

Doing business as

Family Wellness at Teravista

Practice address

4000 Sunrise Rd Ste 3200
Round Rock, TX 78665-1239

Phone

(512) 248-9355

Fax

(512) 233-1010

NPI assigned

Jul 11, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Woodrow Bolden Harris III, D.C.NPI 1881782621

Title

Owner

Phone

(512) 248-9355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Wellness at Teravista Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Woodrow Bolden Harris III, D.C.

  • Chiropractor
  • Round Rock, TX
  • NPI 1881782621
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1366858276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SUNRISE RD STE 3200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651239",
            "telephone_number": "512-248-9355",
            "fax_number": "512-233-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SUNRISE RD STE 3200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651239",
            "telephone_number": "512-248-9355",
            "fax_number": "512-233-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERAVISTA FAMILY WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "WOODROW",
        "authorized_official_middle_name": "BOLDEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-248-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00318024",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Wellness at Teravista",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Wellness at Teravista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.