Fairmont Weight Loss Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

M6-830 Issued in TX

Legal business name

FAIRMONT WEIGHT LOSS CLINIC LLC

Practice address

4416 Fairmont Pkwy Ste 108
Pasadena, TX 77504-3327

Phone

(281) 487-0402

Fax

(281) 487-0348

NPI assigned

Dec 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Juan M Torres

Title

Clinic Manager

Phone

(281) 487-0627

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Debreka Shenette Malone

  • Family Nurse Practitioner
  • Houston, TX
  • NPI 1306341250
  NPD (past)

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1912237702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4416 FAIRMONT PKWY STE 108",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043327",
            "telephone_number": "281-487-0402",
            "fax_number": "281-487-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4416 FAIRMONT PKWY STE 108",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043327",
            "telephone_number": "281-487-0402",
            "fax_number": "281-487-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT WEIGHT LOSS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "281-487-0627",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "M6-830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.