Organization Active NPI

The Wellness Management Group

  • General Practice Physician
  • Houston, TX
National Provider Identifier
1962648006
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G7943 Issued in TX
Legal business name
THE WELLNESS MANAGEMENT GROUP
Practice address
2404 Caroline St
Houston, TX 77004-1016
Phone
(713) 524-4803
Fax
(713) 524-4801
NPI assigned
Dec 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Mr. Lamont Ratcliff
Title
Director
Phone
(713) 524-4803

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G7943 TX
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X G7943 TX
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X G7943 TX
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X G7943 TX Primary

Addresses

Primary practice location

2404 Caroline St
Houston, TX 77004-1016

Mailing address

2404 Caroline St
Houston, TX 77004-1016
Phone (713) 524-4803

Other identifiers 1

IdentifierTypeStateIssuer
129726905MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Gulfcoast Wellness Managemt Group2 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.

Locations

2404 Caroline St
Houston, TX 77004
Phone (281) 501-9071

NPI Registry JSON

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1962648006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 CAROLINE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770041016",
            "telephone_number": "713-524-4803",
            "fax_number": "713-524-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 CAROLINE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770041016",
            "telephone_number": "713-524-4803",
            "fax_number": "713-524-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS MANAGEMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "RATCLIFF",
        "authorized_official_first_name": "LAMONT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-524-4803",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G7943",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "G7943",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "G7943",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "G7943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129726905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 5, 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.