Pristine Serenity Med Spa LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PRISTINE SERENITY MED SPA LLC

Practice address

19121 W Lake Houston Pkwy # 1
Humble, TX 77346-4825

Phone

(832) 819-1415

NPI assigned

Feb 2, 2022

Last updated

Feb 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bianca Robinson

Title

Owner

Phone

(713) 870-9738

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1629721345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14802 BARTON GROVE LN",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964234",
            "telephone_number": "713-870-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19121 W LAKE HOUSTON PKWY # 1",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773464825",
            "telephone_number": "832-819-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE SERENITY MED SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-870-9738"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bianca@pristineserenitymedspa.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19121 W Lake Houston Pkwy # 1",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773464825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• General Practice Physician in Humble, TX
• Providers in Humble, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.