Pearland Total Wellness Clinic, PLLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

PEARLAND TOTAL WELLNESS CLINIC, PLLC

Practice address

15718 S. Highway 288
Suite 110
Pearland, TX 77584

Phone

(800) 246-5698

NPI assigned

Mar 29, 2018

Organization subpart

Yes

Parent organization

MODERN MALE T-CLINIC, P.A.As reported in NPPES

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

Authorized official

Name

Salvatore Campo, DO

Title

DO/Physician

Phone

(800) 246-5698

Specialties & licenses 2

Addresses

Part of

Modern Male T-Clinic PA

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Modern Male T-Clinic, P.a.

  • General Practice Physician
  • Dallas, TX
  • NPI 1518389022
  NPPES parent name

Practitioners 2

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

• Daniel Dao, FNP-C

  • Family Nurse Practitioner
  • Pasadena, TX
  • NPI 1013554427
  NPD (past)
• Quratulain Hayat, DO

  • Family Medicine Physician
  • Rosenberg, TX
  • NPI 1275013237

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1689179756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 ELDORADO PKWY STE 150-153",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750338695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15718 S. HIGHWAY 288",
            "address_2": "SUITE 110",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77584",
            "telephone_number": "800-246-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLAND TOTAL WELLNESS CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MODERN MALE T-CLINIC, P.A.",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "CAMPO",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_title_or_position": "DO/PHYSICIAN",
        "authorized_official_telephone_number": "800-246-5698",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearland Sunrise Medical Center LLC
• Pearland Texas State Optical, Incorporated
• Pearland Therapeutic Services PC
• Pearland Therapeutics LLC
• Pearland Total Bodywork LLC
• Pearland TX Caregiving LLC
• Pearland Unicare Pharmacy LLC
• Pearland Vision Center Incorporated
• Pearland Vision Center LLC
• Pearland Women'S Health, PLLC

• All providers in Pearland, TX
• Adult Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.