Organization Active NPI

Wellness Bay LLC

  • Internal Medicine Physician
  • Georgetown, TX
National Provider Identifier
1407676737
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLNESS BAY LLC
Practice address
4887 Williams Dr Ste 107
Georgetown, TX 78633-2440
Phone
(512) 588-7008
Fax
(888) 440-2690
NPI assigned
Oct 11, 2024
Last updated
Aug 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Dr. Mohammad Al Darawsha, MDNPI 1417443243
Title
Owner
Phone
(512) 588-7008

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4887 Williams Dr Ste 107
Georgetown, TX 78633-2440

Mailing address

4887 Williams Dr Ste 107
Georgetown, TX 78633-2440
Phone (512) 588-7008

Other practice location 1

4875 Williams Dr
Georgetown, TX 78633-2429
Phone (512) 588-7008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241212000883 TX Part B Supplier - Clinic/Group Practice 0941736094 Receives reassigned benefits from 2 practitioners
Practice locations: Georgetown, TX

National Provider Directory

National Provider Directory

Locations

4887 Williams Dr
Ste 107
Georgetown, TX 78633
Phone (512) 588-7008

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1407676737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332440",
            "telephone_number": "512-588-7008",
            "fax_number": "888-440-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332440",
            "telephone_number": "512-588-7008",
            "fax_number": "888-440-2690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4875 Williams Dr",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "TX",
            "postal_code": "786332429",
            "country_code": "US",
            "telephone_number": "512-588-7008",
            "fax_number": "888-440-2690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLNESS BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-11",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "AL DARAWSHA",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-588-7008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.