Incognito Spa Clinic LLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

INCOGNITO SPA CLINIC LLC

Practice address

2201 Arbor St
Houston, TX 77004-6026

Phone

(833) 430-4807

Fax

(833) 430-4807

NPI assigned

Aug 31, 2021

Last updated

Aug 31, 2021By 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

Latasha Krauth

Title

Owner

Phone

(346) 816-9150

Specialties & licenses 2

Addresses

Electronic endpoints 1

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.

• Latasha Johnson

  • Prosthetics Case Management
  • Houston, TX
  • NPI 1962082263
  NPD
• Oluwatoyosi Olumide

  • Family Medicine Physician
  • Houston, TX
  • NPI 1174291926

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1710655139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 ARBOR ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046026",
            "telephone_number": "833-430-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 ARBOR ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046026",
            "telephone_number": "833-430-4807",
            "fax_number": "833-430-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCOGNITO SPA CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "KRAUTH",
        "authorized_official_first_name": "LATASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "346-816-9150"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apar@medcenterbilling.com",
            "affiliation": "Y",
            "affiliationName": "Medcenter Revenue Management",
            "address_1": "2201 Arbor St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770046026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Inclusive Clinics PLLC
• Inclusive Diagnostics, Inc (Inclusive MRI & Diagnostics)
• Inclusive Healthcare Group, LLC
• Inclusive Wellness & Rehabilitation PLLC
• Incognito Salon & Spa, LLC (Third Ward Wellness Clinic / Incognito Spa Clinic)
• Frank Liborio Incrapera, D.D.S.
• Roi Marvin Indefenso, APRN
• Independen Provider
• Independence Care of Texas LLC
• Independence HCS, Inc.

• Public Health & General Preventive Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Public Health & General Preventive Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.