NPIMap

Organization Active NPI

Faith Works Health and Wellness Network

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1487881306
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K1282 Issued in TX
Legal business name
FAITH WORKS HEALTH AND WELLNESS NETWORK
Practice address
4112 Austin St
Houston, TX 77004-4813
Phone
(713) 884-0884
Fax
(713) 583-5877
NPI assigned
Jun 18, 2009
Organization subpart
Yes
Parent organization
BRIDGE RESEARCH FOUNDATION INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Dr. Richard Earl Wilson II, ED. D
Title
Ceo/President
Phone
(713) 884-0884

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 230335 TX
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 230335 TX
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X K1282 TX Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

4112 Austin St
Houston, TX 77004-4813

Mailing address

4112 Austin St
Houston, TX 77004-4813
Phone (713) 884-0884

Other names 1

  • BRIDGE RESEARCH FOUNDATION INCORPORATED Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bridge Research Foundation Incorporated2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1487881306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 AUSTIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770044813",
            "telephone_number": "713-884-0884",
            "fax_number": "713-583-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 AUSTIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770044813",
            "telephone_number": "713-884-0884",
            "fax_number": "713-583-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH WORKS HEALTH AND WELLNESS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIDGE RESEARCH FOUNDATION INCORPORATED",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "713-884-0884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "ED. D"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "230335",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "230335",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1282",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIDGE RESEARCH FOUNDATION INCORPORATED",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.